Preoperative Magnetic Resonance Imaging Diagnosis of Ovarian Torsion

Abstract

Background: Magnetic resonance (MR) imaging, have become more frequently used in the diagnosis of ovarian torsion, particularly in subacute cases. Objectives: To assess the characteristic findings and diagnostic performance of preoperative MR imaging for ovarian torsion. Methods: Twenty-three patients (age range, 10 - 58 years; mean age, 28.4 ± 12.5 years) with suspected ovarian torsion underwent preoperative MR imaging. Fifteen patients exhibited ovarian torsion, whereas the remaining eight did not. Two radiologists evaluated the MR imaging data in relation to six previously-described characteristics associated with ovarian torsion, and the sensitivity, specificity, and accuracy of this approach was determined. Results: Ovarian enlargement (maximum ovarian diameter > 4.0 cm; P = 0.032 for both readers) and a twisted pedicle (P = 0.0094 for reader 1, P = 0.0013 for reader 2) were significantly more common findings in patients with ovarian torsion compared with those without. The respective sensitivity, specificity, and accuracy of a twisted pedicle for the diagnosis of ovarian torsion were 73%, 88%, and 78%, respectively for reader 1 and 73%, 100%, and 83%, respectively for reader 2. Conclusions: Identifying a twisted pedicle in a patient is therefore, suggestive of ovarian torsion. Keywords: Magnetic Resonance Imaging; Ovary; Ovarian Torsion; Twisted Pedicle