Adnexal Torsion (Review of Radiologic Appearances)


Associated Professor of Ahvaz Jundishapour University



Torsion of ovary and fallopian tube or both Are cause of 3% of gynecologic emergencies Right side acute sever pelvic pain of reproductive age of women without febrile is
the common clinical sign. But it can occur in post-menopausal and children.
Unilateral adnexal mass, pregnancy, ovarian hyper stimulation, pelvic surgery, ovarian mass larger than 5cm and lax supporting ligaments are predisposing factor.
Enlarged ovary with heterogeneous stromal echo due to edema and infarct is the basic sonography sign. atypical midline located
Ovary with echogenic wall of follicles and free fluid are specific sign of torsion in sonography.
Doppler sign is variable and normal sonogram does not excluded torsion, because ovaries have dual blood supply.
Whirlpool sign of twisted vascular pedicle Is also specific sign in Doppler study
MRI is problem solving with visualized enlarged ovary with midline position and
Dark follicle wall which are located periphery. non enhancement of ovary
Confirmed non-viable ovary.
Oophorities, PID and ovarian metastasis Are differential diagnosis in imaging.