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Preoperative Sonographic and Clinical Characteristics as Predictors of Ovarian Torsion
Author(s) -
Shadinger Libby L.,
Andreotti Rochelle F.,
Kurian Rachel L.
Publication year - 2008
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2008.27.1.7
Subject(s) - medicine , ovarian torsion , abdominal pain , ovary , radiology , surgery
Objective The purpose of this study was to determine the most closely associated sonographic and clinical characteristics of ovarian torsion. Methods The medical records and sonographic studies of 39 patients with pathologically proven ovarian torsion diagnosed at our institution from July 1, 2000, through December 31, 2005, were retrospectively reviewed. The volumes of the affected ovaries and ovary/mass complexes were compared with an age‐appropriate standard. Statistical significance of the data was assessed by a likelihood ratio χ 2 analysis. Results All patients (100%) had a chief symptom of abdominal pain. Thirty‐three (85%) reported vomiting; 22 (56%) had leukocytosis; and 7 (18%) had a documented elevated temperature. All affected ovaries and ovary/mass complexes were enlarged. Twenty‐one (54%) had arterial flow on Doppler interrogation, and 18 (46%) had no arterial flow. Thirteen (33%) had venous flow, and 26 (67%) had no venous flow. Differences in the arterial and venous flow patterns between the premenarchal and reproductive age groups were not statistically significant. Conclusions Abdominal pain, vomiting, ovarian enlargement, and absence of ovarian venous Doppler flow are the most frequently shown clinical and sonographic indicators of ovarian torsion. However, ovarian enlargement, even in the presence of arterial and venous Doppler flow, is the most commonly associated sonographic finding. Suspicion of ovarian torsion should be high in the setting of clinical symptoms and ovarian enlargement regardless of the presence or absence of an ovarian Doppler signal.