Adnexal torsion: MR imaging findings of viable ovary

Haque, Tabassum Laz; Togashi, Kaori; Kobayashi, Hisataka; Fujii, Shingo; Konishi, Junji

doi:10.1007/s003300000461

Cited by 27 publications

(14 citation statements)

References 4 publications

(11 reference statements)

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“…3,11,12 Furthermore, due to passive congestion, T 1 -weighted images depicted a torsed ovary without hemorrhagic infarction as hyperintense. 13 Methemoglobin generated during the subacute phase of hemorrhage causes shortening of T 1 relaxation time that results in hyperintensity on T 1 -weighted images. On the other hand, acute hemorrhage containing oxy-or deoxyhemoglobin is depicted as iso-or hypointense on T 1 -weighted images.…”

Section: Discussionmentioning

confidence: 99%

“…Hyperintensity of enlarged ovarian stroma on T 2 -weighted images may indicate an edematous condition in viable torsed ovaries, 13,14 whereas hypointensity may indicate hemorrhagic infarction. 3,11,12 In our series, we observed no significant difference in signal intensity ratios on T 2 -weighted images between patients with and without hemorrhagic infarction, probably because signal intensity on T 2 -weighted images varies during the course of hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

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Diffusion-weighted Imaging of Ovarian Torsion: Usefulness of Apparent Diffusion Coefficient (ADC) Values for the Detection of Hemorrhagic Infarction

et al. 2014

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Purpose: We undertook this study to evaluate the need for diffusion-weighted (DW) magnetic resonance (MR) imaging in detecting hemorrhagic infarction following ovarian torsion.Methods: The study included 14 consecutive patients aged 12 to 74 years (average age, 36 years) with surgical confirmation of ovarian torsion who underwent 1.5-tesla MR imaging. Pathologically, hemorrhagic infarction was found in 7 patients. We retrospectively reviewed signal intensity on T 1 -, T 2 -, and diffusion-weighted images and apparent diffusion coefficients (ADCs) in swollen ovarian stroma.Results: Fallopian tube thickening was seen in all patients. In patients with ovarian cystic lesion, maximum cyst wall thickness was significantly higher in patients with hemorrhagic infarction (mean, 13.5 « 4.1 mm) than those without (mean, 5.0 « 1.0 mm) (P < .05). Signal intensity did not differ significantly on T 1 -weighted, T 2 -weighted, and DW images between patients with and without hemorrhagic infarction. ADCs were significantly lower in patients with hemorrhagic infarction (1.20 « 0.50 [© 10 ¹3 mm 2 /s]) than those without (2.04 « 0.26 [© 10 ¹3 mm 2 /s]) (P < .01). With an ADC threshold of 1.80 [© 10 ¹3 mm 2 /s], sensitivity for hemorrhagic infarction was 0.88 (7 of 8), and specificity was 1.00 (6 of 6).Conclusion: ADC measurements were useful for detecting hemorrhagic infarction in patients with ovarian torsion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diffusion-weighted Imaging of Ovarian Torsion: Usefulness of Apparent Diffusion Coefficient (ADC) Values for the Detection of Hemorrhagic Infarction

et al. 2014

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“…In the early stages, a torsed ovary may be swollen and contain multiple follicles separated by edematous stroma [2]. Hyperintense signal of enlarged ovarian stroma on T2-weighted images probably related to edema can be useful findings in viable torsions [18,19]. When hemorrhagic necrosis occurs, the lesion may exhibit high intensity on T1-weighted images [17,20].…”

Section: Solid/solid and Cystic Lesionsmentioning

confidence: 96%

“…When hemorrhagic necrosis occurs, the lesion may exhibit high intensity on T1-weighted images [17,20]. Identification of the enhancement on postcontrast MR images is an important finding for suggesting the viable tissues in the affected ovary [19]. Lack of enhancement in Fig.…”

Section: Solid/solid and Cystic Lesionsmentioning

confidence: 97%

MR features of physiologic and benign conditions of the ovary

et al. 2006

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In reproductive women, various physiologic conditions can cause morphologic changes of the ovary, resembling pathologic conditions. Benign ovarian diseases can also simulate malignancies. Magnetic resonance imaging (MRI) can play an important role in establishing accurate diagnosis. Functional cysts should not be confused with cystic neoplasms. Corpus luteum cysts typically have a thick wall and are occasionally hemorrhagic. Multicystic lesions that may mimic cystic neoplasms include hyperreactio luteinalis, ovarian hyperstimulation syndrome, and polycystic ovary syndrome. Recognition of clinical settings can help establish diagnosis. In endometrial cysts, MRI usually provides specific diagnosis; however, decidual change during pregnancy should not be confused with secondary neoplasm. Peritoneal inclusion cysts can be distinguished from cystic neoplasms by recognition of their characteristic configurations. Ovarian torsion and massive ovarian edema may mimic solid malignant tumors. Recognition of normal follicles and anatomic structures is useful in diagnosing these conditions. In pelvic inflammatory diseases, transfascial spread of the lesion should not be confused with invasive malignant tumors. Radiologic identification of abscess formation can be a diagnostic clue. Many benign tumors, including teratoma, Brenner tumor, and sex-cord stromal tumor, frequently show characteristic MRI features. Knowledge of MRI features of these conditions is essential in establishing accurate diagnosis and determining appropriate treatment.

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“…The development of threedimensional sonography may enhance the diagnostic potential of ultrasound [13]. It has also been suggested that magnetic resonance imaging (MRI) has a role in assessing ovarian viability in cases of torsion [14,15].…”

Section: Introductionmentioning

confidence: 99%

Ovarian conservation in adnexal torsion-a report of six cases

North¹,

Nardo²,

Mokate³

et al. 2007

Gynecol Surg

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Adnexal torsion is an uncommon but important cause of emergency admission to the gynaecologist. Treatment of adnexal torsion has traditionally involved surgical excision of the affected structure, usually via laparotomy. A more conservative surgical approach of untwisting the torsion has been widely reported in paediatric cases. Despite reports of the successful treatment of torsion with this approach in the adult population, many UK surgeons remain reluctant to attempt ovarian conserving surgery, particularly via the laparoscopic route.We report six cases of conservative surgery for adnexal torsion. After initial success via laparotomy, the subsequent five cases were managed laparoscopically. We discuss the advantages and disadvantages of this management approach.

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Adnexal torsion: MR imaging findings of viable ovary

Cited by 27 publications

References 4 publications

Diffusion-weighted Imaging of Ovarian Torsion: Usefulness of Apparent Diffusion Coefficient (ADC) Values for the Detection of Hemorrhagic Infarction

Diffusion-weighted Imaging of Ovarian Torsion: Usefulness of Apparent Diffusion Coefficient (ADC) Values for the Detection of Hemorrhagic Infarction

MR features of physiologic and benign conditions of the ovary

Ovarian conservation in adnexal torsion-a report of six cases

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