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Journal of Ultrasound in Medicine, Vol 17, Issue 2 83-89, Copyright © 1998 by American Institute of Ultrasound in Medicine
Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle
E. J. Lee, H. C. Kwon, H. J. Joo, J. H. Suh and A. C. Fleischer
Department of Radiology, Ajou University, College of Medicine, Kyunggi-do, South Korea.
The purpose of this study was to assess the diagnostic value of
ultrasonography for the detection of twisted vascular pedicle in ovarian
torsion and to verify whether the blood flow alterations in the twisted
vascular pedicle on color Doppler sonography can predict the viability of
adnexal structures. In 28 of 32 patients with surgically proved torsion,
the twisted vascular pedicle was detected preoperatively by
ultrasonography, which shows a diagnostic accuracy of 87%. Arterial and
venous flows were present in the twisted vessels on color Doppler
sonography in 16 of 28 patients with a visible twisted vascular pedicle. In
11 patients who underwent adnexectomy, the pathologic findings revealed
nonnecrotic ovaries in 10 patients. Untwisting of the twisted vascular
pedicle was performed in five patients, and follow-up ultrasonography
showed normal follicular development and ovulation. All 12 patients who
showed no blood flow within the twisted vascular pedicle had necrotic
ovaries. In conclusion, identification of the twisted vascular pedicle
through ultrasonography is suggestive of ovarian torsion, and color Doppler
sonography could be helpful in predicting the viability of adnexal
structures by depicting blood flow within the twisted vascular pedicle.
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