Evidence map›Paper›PMID 38937346›Full record

ArticleEmergency radiology2024

Deciphering ovarian torsion: insights from CT imaging analysis.

Snehal Rathi, Patrick J Navin, Pranav Ajmera, Dave Bartlett, Ceylan Colak, Ashish Khandelwal

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Article in Emergency radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Snehal RathiDepartment of Radiology, Mayo Clinic, Rochester, USA.
Patrick J NavinDepartment of Radiology, Mayo Clinic, Rochester, USA.
Pranav AjmeraDepartment of Radiology, Mayo Clinic, Rochester, USA.
Dave BartlettDepartment of Radiology, Mayo Clinic, Rochester, USA.
Ceylan ColakDepartment of Radiology, Mayo Clinic, Rochester, USA.
Ashish KhandelwalDepartment of Radiology, Mayo Clinic, Rochester, USA. khandelwal.ashish@mayo.edu.ORCID http://orcid.org/0000-0002-2728-7799

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn the milieu of emergency medicine, pelvic and lower abdominal pain present recurrently, with ovarian torsion posing a formidable diagnostic quandary amid multifarious etiologies. Given the burgeoning reliance on CT in acute care settings, it invariably assumes primacy as the principal imaging modality. This study endeavors to elucidate the CT imaging manifestations encountered by surgically confirmed ovarian torsion patients and utilizing CT to differentiate necrosis.

methodsA retrospective analysis (January, 2015- April, 2019) utilizing hospital archives was conducted on patients diagnosed with ovarian torsion, post-surgery. Inclusion criteria encompassed patients who underwent CT examinations within one week of diagnosis. A large array of CT findings encompassing midline orientation, uterine deviation, intraovarian hematoma/mass, and multiple others were systematically documented.

results90 patients were diagnosed with ovarian torsion- 53 (59%) had CT within one week of diagnosis, 41(77%) underwent a CT with IV contrast and 12 (23%) without IV contrast. Mean age was 43 years (range 19-77 years), with near equal distribution of involvement of each ovary. Mean maximum ovarian diameter was 11.7 ± 6.3 cm (4.2-34.8 cm). Most common imaging features include the presence of thickened pedicle (43/53, 81%), midline ovary (41/53, 77%), presence of thickened fallopian tube (31/49, 63%), and ipsilateral uterine deviation (33/53, 62%). Based on contemporaneous imaging report, torsion was diagnosed in 25/ 53 studies giving a sensitivity of 47%.

conclusionEnlarged ovarian dimensions (> 3.0 cm), thickened vascular pedicle or fallopian tube, midline ovarian disposition with ipsilateral uterine deviation, and the presence of a whirlpool sign emerged as predominant CT imaging features in surgically confirmed ovarian torsion cases, serving as pivotal diagnostic aides for radiologists. Concomitant pelvic free fluid and intraovarian hematoma signify necrotic changes, indicative of ischemic severity and disease progression.

Indexed as

Ovarian TorsionTomography, X-Ray ComputedAdultAgedContrast MediaDiagnosis, DifferentialFemaleHumansMiddle AgedRetrospective StudiesContrast MediaCTImagingLaparoscopyOvarian torsionSurgical emergency

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.