MR Diagnosis of Ovarian Torsion

Article Information

Aruna Singh MD1, Lokesh Singh MD2*

1Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India

2Department of Radio diagnosis and Imaging, PGIMER, Chandigarh, India

*Corresponding Author: Lokesh Singh MD, Department of Radio diagnosis and Imaging, PGIMER, Chandigarh, India

Received: 20 October 2020; Accepted: 11 December 2020; Published: 04 January 2021

Citation: Aruna Singh, Lokesh Singh. MR Diagnosis of Ovarian Torsion. Archives of Clinical and Medical Case Reports 5 (2021): 54-55.

View / Download Pdf Share at Facebook

Keywords

Ovarian Torsion; Pelvic inflammatory disease; Cystic mass

Ovarian Torsion articles; Pelvic inflammatory disease articles; Cystic mass articles

Ovarian Torsion articles Ovarian Torsion Research articles Ovarian Torsion review articles Ovarian Torsion PubMed articles Ovarian Torsion PubMed Central articles Ovarian Torsion 2023 articles Ovarian Torsion 2024 articles Ovarian Torsion Scopus articles Ovarian Torsion impact factor journals Ovarian Torsion Scopus journals Ovarian Torsion PubMed journals Ovarian Torsion medical journals Ovarian Torsion free journals Ovarian Torsion best journals Ovarian Torsion top journals Ovarian Torsion free medical journals Ovarian Torsion famous journals Ovarian Torsion Google Scholar indexed journals Torsion articles Torsion Research articles Torsion review articles Torsion PubMed articles Torsion PubMed Central articles Torsion 2023 articles Torsion 2024 articles Torsion Scopus articles Torsion impact factor journals Torsion Scopus journals Torsion PubMed journals Torsion medical journals Torsion free journals Torsion best journals Torsion top journals Torsion free medical journals Torsion famous journals Torsion Google Scholar indexed journals Pelvic inflammatory disease articles Pelvic inflammatory disease Research articles Pelvic inflammatory disease review articles Pelvic inflammatory disease PubMed articles Pelvic inflammatory disease PubMed Central articles Pelvic inflammatory disease 2023 articles Pelvic inflammatory disease 2024 articles Pelvic inflammatory disease Scopus articles Pelvic inflammatory disease impact factor journals Pelvic inflammatory disease Scopus journals Pelvic inflammatory disease PubMed journals Pelvic inflammatory disease medical journals Pelvic inflammatory disease free journals Pelvic inflammatory disease best journals Pelvic inflammatory disease top journals Pelvic inflammatory disease free medical journals Pelvic inflammatory disease famous journals Pelvic inflammatory disease Google Scholar indexed journals Cystic mass articles Cystic mass Research articles Cystic mass review articles Cystic mass PubMed articles Cystic mass PubMed Central articles Cystic mass 2023 articles Cystic mass 2024 articles Cystic mass Scopus articles Cystic mass impact factor journals Cystic mass Scopus journals Cystic mass PubMed journals Cystic mass medical journals Cystic mass free journals Cystic mass best journals Cystic mass top journals Cystic mass free medical journals Cystic mass famous journals Cystic mass Google Scholar indexed journals MRI  articles MRI  Research articles MRI  review articles MRI  PubMed articles MRI  PubMed Central articles MRI  2023 articles MRI  2024 articles MRI  Scopus articles MRI  impact factor journals MRI  Scopus journals MRI  PubMed journals MRI  medical journals MRI  free journals MRI  best journals MRI  top journals MRI  free medical journals MRI  famous journals MRI  Google Scholar indexed journals treatment articles treatment Research articles treatment review articles treatment PubMed articles treatment PubMed Central articles treatment 2023 articles treatment 2024 articles treatment Scopus articles treatment impact factor journals treatment Scopus journals treatment PubMed journals treatment medical journals treatment free journals treatment best journals treatment top journals treatment free medical journals treatment famous journals treatment Google Scholar indexed journals Adenocarcinoma articles Adenocarcinoma Research articles Adenocarcinoma review articles Adenocarcinoma PubMed articles Adenocarcinoma PubMed Central articles Adenocarcinoma 2023 articles Adenocarcinoma 2024 articles Adenocarcinoma Scopus articles Adenocarcinoma impact factor journals Adenocarcinoma Scopus journals Adenocarcinoma PubMed journals Adenocarcinoma medical journals Adenocarcinoma free journals Adenocarcinoma best journals Adenocarcinoma top journals Adenocarcinoma free medical journals Adenocarcinoma famous journals Adenocarcinoma Google Scholar indexed journals surgery articles surgery Research articles surgery review articles surgery PubMed articles surgery PubMed Central articles surgery 2023 articles surgery 2024 articles surgery Scopus articles surgery impact factor journals surgery Scopus journals surgery PubMed journals surgery medical journals surgery free journals surgery best journals surgery top journals surgery free medical journals surgery famous journals surgery Google Scholar indexed journals SARS-COV-2 articles SARS-COV-2 Research articles SARS-COV-2 review articles SARS-COV-2 PubMed articles SARS-COV-2 PubMed Central articles SARS-COV-2 2023 articles SARS-COV-2 2024 articles SARS-COV-2 Scopus articles SARS-COV-2 impact factor journals SARS-COV-2 Scopus journals SARS-COV-2 PubMed journals SARS-COV-2 medical journals SARS-COV-2 free journals SARS-COV-2 best journals SARS-COV-2 top journals SARS-COV-2 free medical journals SARS-COV-2 famous journals SARS-COV-2 Google Scholar indexed journals tomography articles tomography Research articles tomography review articles tomography PubMed articles tomography PubMed Central articles tomography 2023 articles tomography 2024 articles tomography Scopus articles tomography impact factor journals tomography Scopus journals tomography PubMed journals tomography medical journals tomography free journals tomography best journals tomography top journals tomography free medical journals tomography famous journals tomography Google Scholar indexed journals

Article Details

Case Report

A 20 year unmarried female presented with sudden onset pain in pelvis, predominantly on right side with associated nausea and vomiting. On examination, there was presence of a palpable lump in right iliac fossa with tenderness. Rest of her general physical examination was normal. Her menstrual history was regular. Clinical differential diagnosis of appendicitis, diverticulitis and ovarian torsion were kept. An ultrasound was performed which showed presence of right adnexal cystic mass with engorged vessels suggestive of ovarian torsion. Left ovary was normal.

A pelvic MRI (Figure 1) was performed to confirm the diagnosis which revealed a 7.5 × 6 cm cystic mass in right ovary with T2 shading and Fluid levels. Few follicles were seen at the periphery of the lesion. There was engorgement of pedicle with deviation of uterus towards right side. All these findings confirmed the findings of right ovarian torsion. The classical presentation of ovarian torsion is acute onset colicky pain in pelvis with radiation to the ipsilateral flank or groin [1]. There can be tenderness and presence of a mass on pelvic examination. Sometimes patients can have intermittent history of pain with self limiting course [2].

Imaging features on MRI are presence of an enlarged ovary with or without an underlying mass, twisted pedicle with or without ovarian hematoma and abnormal ovarian enhancement [3, 4]. Some other features include ascites, ipsilateral deviation of the uterus to the side of the twist, vessel and thickening of fallopian tube. Peripheral follicles can be seen on T2w and post contrast sequences. Contrast administration is done to assess for demonstrating abnormal enhancement, detection of mass and visualization of engorged twisted pedicle. Differential diagnoses include appendicitis, diverticulitis, pelvic inflammatory disease, renal colic and endometriosis and laparoscopy may be required for confirmation of diagnosis [5].

fortune-biomass-feedstock

Figure 1: Axial T2w MRI (a) shows presence of cystic right adnexal mass with fluid level (thick white arrow) and presence of peripheral follicles (thin white arrows). Post contrast axial MRI pelvis; (b) shows ipsilateral deviation of uterus (thick black arrow) with engorged pedicle (thin black arrow).

Conflicts of Interests

NIL.

Funding

NIL.

References

  1. Houry D, Abbot J. Ovarian torsion a fifteen year review. Ann Emerg Med 38 (2001): 156-159.
  2. Albayram F, Hamper UM. Ovarian and adnexal torsion: spectrum of sonographic findings with pathologic correlation. J Ultrasound Med 20 (2001): 1083-1089.
  3. Kiumura I, Togashi K, Kawakami S, et al. Ovarian torsion: CT and MRI imaging features. Radiology 190 (1994): 337-341.
  4. Rha SE, Byun JY, Jung SE, et al. CT and MR imaging features of adnexal torsion. Radio Graphics 22 (2002): 283-294.
  5. Hibbard LT. Adnexal torsion. Am J Obstet Gynecol 152 (1985): 456-461.

© 2016-2024, Copyrights Fortune Journals. All Rights Reserved