Contribution of diffusion-weighted imaging to conventional MRI for detection of haemorrhagic infarction in ovary torsion

Abstract

BackgroundTo assess the role of DWI in differentiation haemorrhagic ovary infarction from non-haemorrhagic one.MethodsFor this prospectively designed study, of 117 female patients who presented with acute lower quadrant pain and underwent MRI for suspicion of ovary torsion, results of only 29 patients (mean age, 24.7; SD, ±5.7; age range, 18–37), with surgical and pathological confirmation of adnexal torsion, were included to the study. All patients underwent DWI after conventional MRI. Quantitative and qualitative analysis of both the torsed and contralateral normal ovary were performed. Results of conventional MRI and DWI were noted.ResultsAt operation 15 patients were found to have haemorrhagic infarction while 14 had non-haemorrhagic infarction. Of the 29 patients, 17 torsed ovaries could be salvaged in a viable state. We found statistically significant correlation of the ADC values, between haemorrhagic and non-haemorrhagic ovary infarction. The ADC values were significantly lower in patients with haemorrhagic infarction than non-haemorrhagic ones (p < 0.001). Using an ADC threshold of 1.27, the sensitivity of DWI for haemorrhagic infarction was 0.93 and specificity 0.85.ConclusionDWI may be used with a significant success for the preoperative diagnosis of haemorrhagic infarction. This may be alerting for pre-emptive surgery in avoiding serious complications and preventing irreversible structural damage of the ovary.

Teratoma of the greater omentum: An extremely rare case report

“…CT and magnetic resonance imaging (MRI) are the problem solving imaging tools to further evaluate the adnexal masses. Besides, MRI with its high soft tissue resolution has the advantage to characterize the primary ovarian masses, to depict the adnexal anatomy, and to help in the diagnosis of ovary torsion and its possible complications [9]. It is clear that MRI is also an efficient imaging method for diagnosing extragonadal teratomas as well as scanning the ovaries at the same time.…”

All that glitters are not gold: holds true in female adnexal lesions

“…In ovary with torsion, the mean ADC valueis lower than that of ovary without torsion. And it is significantly lower in patients with hemorrhagic infarction [20]. Torsion leads to cytotoxic edema and causes diffusion restriction on DWI [21].…”

How Can Pelvic MRI with Diffusion-Weighted Imaging Help My Pregnant Patient?

“…DWI has proven to be a viable technique for evaluating acute processes in the absence of gadolinium. [17][18][19][20][21][22][23] Acute Pelvic Pain: Appendicitis MRI is beneficial in the diagnosis of acute pelvic pain in pregnant women, especially when it is caused by bowel pathology such as appendicitis or Crohn's disease. In these cases, DWI helps in the diagnosis and assessing for complications in the absence of gadolinium.…”

“…Torsed ovaries can show high signal on high b value DWI from edema, and also from hemorrhage within the ovary. 52 DWI and ADC measurements can be useful for detecting hemorrhagic infarction, 18,23,53 which has potential to guide surgical planning to determine whether an ovary can be detorsed or if it will need to be resected.…”