Bookmarks
KEY FACTS
Terminology
Imaging
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Adnexal torsion, twisted ovary
Definitions
- Twisting of vascular pedicle of ovary, fallopian tube, or both → venous obstruction → edema → arterial compromise → ischemia → hemorrhagic infarction
IMAGING
General Features
Ultrasonographic Findings
MR Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Alberto EC et al: Variations in the management of adolescent adnexal torsion at a single institution and the creation of a unified care pathway. Pediatr Surg Int. 37(1):129-35, 2021
- Dawood MT et al: Adnexal torsion: review of radiologic appearances. Radiographics. 41(2):609-24, 2021
- Gounder S et al: Multimodality imaging review for suspected ovarian torsion cases in children. Radiography (Lond). 27(1):236-42, 2021
- Hartman SJ et al: Ovarian volume ratio is a reliable predictor of ovarian torsion in girls without an adnexal mass. J Pediatr Surg. 56(1):180-2, 2021
- Strachowski LM et al: Pearls and pitfalls in imaging of pelvic adnexal torsion: seven tips to tell it's twisted. Radiographics. 41(2):625-40, 2021
- Lipsett SC et al: Variation in oophorectomy rates for children with ovarian torsion across US children's hospitals. J Pediatr. 231:269-72., 2020
- Otjen JP et al: Ovarian torsion: developing a machine-learned algorithm for diagnosis. Pediatr Radiol. 50(5):706-14, 2020
- Rougier E et al: Added value of MRI for the diagnosis of adnexal torsion in children and adolescents after inconclusive ultrasound examination. Diagn Interv Imaging. 101(11):747-56, 2020
- Adnexal Torsion in Adolescents: ACOG committee opinion No, 783 summary. Obstet Gynecol. 134(2):435-6, 2019
- Ayaz E et al: Evaluation of ovarian vascularity in children by using the "superb microvascular imaging" ultrasound technique in comparison with conventional doppler ultrasound techniques. J Ultrasound Med. 38(10):2751-760, 2019
- Prieto JM et al: Premenarchal patients present differently: a twist on the typical patient presenting with ovarian torsion. J Pediatr Surg. 54(12):2614-6, 2019
- Shapira-Zaltsberg G et al: Non-visualization of the ovaries on pediatric transabdominal ultrasound with a non-distended bladder: Can adnexal torsion be excluded? Pediatr Radiol. 49(10):1313-9, 2019
- Buicko JL et al: Disparities in pediatric gonadal torsion: does gender, race and insurance status affect outcomes? J Pediatr Surg. 53(7):1392-5, 2018
- Sintim-Damoa A et al: Pediatric ovarian torsion: spectrum of imaging findings. Radiographics. 37(6):1892-908, 2017
- Rey-Bellet Gasser C et al: Is it ovarian torsion? A systematic literature review and evaluation of prediction signs. Pediatr Emerg Care. 32(4):256-61, 2016
- Smorgick N et al: High risk of recurrent torsion in premenarchal girls with torsion of normal adnexa. Fertil Steril. 105(6):1561-5, 2016
- Bronstein ME et al: A meta-analysis of B-mode ultrasound, doppler ultrasound, and computed tomography to diagnose pediatric ovarian torsion. Eur J Pediatr Surg. 25(1):82-6, 2015
- Ngo AV et al: Pediatric ovarian torsion: a pictorial review. Pediatr Radiol. 45(12):1845-55; quiz 1842-4, 2015
- Oskaylı MÇ et al: Surgical approach to ovarian torsion in children. J Pediatr Adolesc Gynecol. 28(5):343-7, 2015
- Ozcan HN et al: Imaging findings of fetal-neonatal ovarian cysts complicated with ovarian torsion and autoamputation. AJR Am J Roentgenol. 205(1):185-9, 2015
- Sola R et al: National trends in the surgical treatment of ovarian torsion in children: An analysis of 2041 pediatric patients utilizing the nationwide inpatient sample. Am Surg. 81(9):844-8, 2015
- Hyttel TE et al: Re-torsion of the ovaries. Acta Obstet Gynecol Scand. 94(3):236-44, 2014
- Lourenco AP et al: Ovarian and tubal torsion: imaging findings on US, CT, and MRI. Emerg Radiol. 21(2):179-87, 2014
- Narayanan S et al: Fallopian tube torsion in the pediatric age group: radiologic evaluation. J Ultrasound Med. 33(9):1697-704, 2014
- Swenson DW et al: Ovarian torsion: case-control study comparing the sensitivity and specificity of ultrasonography and computed tomography for diagnosis in the emergency department. Eur J Radiol. 83(4):733-8, 2014
- Appelbaum H et al: Key clinical predictors in the early diagnosis of adnexal torsion in children. J Pediatr Adolesc Gynecol. 26(3):167-70, 2013
- Geimanaite L et al: Ovarian torsion in children: management and outcomes. J Pediatr Surg. 48(9):1946-53, 2013
- Navve D et al: Medial or lateral location of the whirlpool sign in adnexal torsion: clinical importance. J Ultrasound Med. 32(9):1631-4, 2013
- Schmitt ER et al: Twist and shout! Pediatric ovarian torsion clinical update and case discussion. Pediatr Emerg Care. 29(4):518-23; quiz 524-6, 2013
- Wilkinson C et al: Adnexal torsion -- a multimodality imaging review. Clin Radiol. 67(5):476-83, 2012
- Cheng KL et al: Ovarian torsion: appearance on MRI. Pediatr Radiol. 40 Suppl 1:S104, 2010
- Chang HC et al: Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics. 28(5):1355-68, 2008
- Linam LE et al: US findings of adnexal torsion in children and adolescents: size really does matter. Pediatr Radiol. 37(10):1013-9, 2007
- Abes M et al: Oophoropexy in children with ovarian torsion. Eur J Pediatr Surg. 14(3):168-71, 2004
- Beaunoyer M et al: Asynchronous bilateral ovarian torsion. J Pediatr Surg. 39(5):746-9, 2004
- Vijayaraghavan SB: Sonographic whirlpool sign in ovarian torsion. J Ultrasound Med. 23(12):1643-9; quiz 1650-1, 2004
- Hurh PJ et al: Ultrasound of a torsed ovary: characteristic gray-scale appearance despite normal arterial and venous flow on Doppler. Pediatr Radiol. 32(8):586-8, 2002
- Rha SE et al: CT and MR imaging features of adnexal torsion. Radiographics. 22(2):283-94, 2002
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Adnexal torsion, twisted ovary
Definitions
- Twisting of vascular pedicle of ovary, fallopian tube, or both → venous obstruction → edema → arterial compromise → ischemia → hemorrhagic infarction
IMAGING
General Features
Ultrasonographic Findings
MR Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Alberto EC et al: Variations in the management of adolescent adnexal torsion at a single institution and the creation of a unified care pathway. Pediatr Surg Int. 37(1):129-35, 2021
- Dawood MT et al: Adnexal torsion: review of radiologic appearances. Radiographics. 41(2):609-24, 2021
- Gounder S et al: Multimodality imaging review for suspected ovarian torsion cases in children. Radiography (Lond). 27(1):236-42, 2021
- Hartman SJ et al: Ovarian volume ratio is a reliable predictor of ovarian torsion in girls without an adnexal mass. J Pediatr Surg. 56(1):180-2, 2021
- Strachowski LM et al: Pearls and pitfalls in imaging of pelvic adnexal torsion: seven tips to tell it's twisted. Radiographics. 41(2):625-40, 2021
- Lipsett SC et al: Variation in oophorectomy rates for children with ovarian torsion across US children's hospitals. J Pediatr. 231:269-72., 2020
- Otjen JP et al: Ovarian torsion: developing a machine-learned algorithm for diagnosis. Pediatr Radiol. 50(5):706-14, 2020
- Rougier E et al: Added value of MRI for the diagnosis of adnexal torsion in children and adolescents after inconclusive ultrasound examination. Diagn Interv Imaging. 101(11):747-56, 2020
- Adnexal Torsion in Adolescents: ACOG committee opinion No, 783 summary. Obstet Gynecol. 134(2):435-6, 2019
- Ayaz E et al: Evaluation of ovarian vascularity in children by using the "superb microvascular imaging" ultrasound technique in comparison with conventional doppler ultrasound techniques. J Ultrasound Med. 38(10):2751-760, 2019
- Prieto JM et al: Premenarchal patients present differently: a twist on the typical patient presenting with ovarian torsion. J Pediatr Surg. 54(12):2614-6, 2019
- Shapira-Zaltsberg G et al: Non-visualization of the ovaries on pediatric transabdominal ultrasound with a non-distended bladder: Can adnexal torsion be excluded? Pediatr Radiol. 49(10):1313-9, 2019
- Buicko JL et al: Disparities in pediatric gonadal torsion: does gender, race and insurance status affect outcomes? J Pediatr Surg. 53(7):1392-5, 2018
- Sintim-Damoa A et al: Pediatric ovarian torsion: spectrum of imaging findings. Radiographics. 37(6):1892-908, 2017
- Rey-Bellet Gasser C et al: Is it ovarian torsion? A systematic literature review and evaluation of prediction signs. Pediatr Emerg Care. 32(4):256-61, 2016
- Smorgick N et al: High risk of recurrent torsion in premenarchal girls with torsion of normal adnexa. Fertil Steril. 105(6):1561-5, 2016
- Bronstein ME et al: A meta-analysis of B-mode ultrasound, doppler ultrasound, and computed tomography to diagnose pediatric ovarian torsion. Eur J Pediatr Surg. 25(1):82-6, 2015
- Ngo AV et al: Pediatric ovarian torsion: a pictorial review. Pediatr Radiol. 45(12):1845-55; quiz 1842-4, 2015
- Oskaylı MÇ et al: Surgical approach to ovarian torsion in children. J Pediatr Adolesc Gynecol. 28(5):343-7, 2015
- Ozcan HN et al: Imaging findings of fetal-neonatal ovarian cysts complicated with ovarian torsion and autoamputation. AJR Am J Roentgenol. 205(1):185-9, 2015
- Sola R et al: National trends in the surgical treatment of ovarian torsion in children: An analysis of 2041 pediatric patients utilizing the nationwide inpatient sample. Am Surg. 81(9):844-8, 2015
- Hyttel TE et al: Re-torsion of the ovaries. Acta Obstet Gynecol Scand. 94(3):236-44, 2014
- Lourenco AP et al: Ovarian and tubal torsion: imaging findings on US, CT, and MRI. Emerg Radiol. 21(2):179-87, 2014
- Narayanan S et al: Fallopian tube torsion in the pediatric age group: radiologic evaluation. J Ultrasound Med. 33(9):1697-704, 2014
- Swenson DW et al: Ovarian torsion: case-control study comparing the sensitivity and specificity of ultrasonography and computed tomography for diagnosis in the emergency department. Eur J Radiol. 83(4):733-8, 2014
- Appelbaum H et al: Key clinical predictors in the early diagnosis of adnexal torsion in children. J Pediatr Adolesc Gynecol. 26(3):167-70, 2013
- Geimanaite L et al: Ovarian torsion in children: management and outcomes. J Pediatr Surg. 48(9):1946-53, 2013
- Navve D et al: Medial or lateral location of the whirlpool sign in adnexal torsion: clinical importance. J Ultrasound Med. 32(9):1631-4, 2013
- Schmitt ER et al: Twist and shout! Pediatric ovarian torsion clinical update and case discussion. Pediatr Emerg Care. 29(4):518-23; quiz 524-6, 2013
- Wilkinson C et al: Adnexal torsion -- a multimodality imaging review. Clin Radiol. 67(5):476-83, 2012
- Cheng KL et al: Ovarian torsion: appearance on MRI. Pediatr Radiol. 40 Suppl 1:S104, 2010
- Chang HC et al: Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics. 28(5):1355-68, 2008
- Linam LE et al: US findings of adnexal torsion in children and adolescents: size really does matter. Pediatr Radiol. 37(10):1013-9, 2007
- Abes M et al: Oophoropexy in children with ovarian torsion. Eur J Pediatr Surg. 14(3):168-71, 2004
- Beaunoyer M et al: Asynchronous bilateral ovarian torsion. J Pediatr Surg. 39(5):746-9, 2004
- Vijayaraghavan SB: Sonographic whirlpool sign in ovarian torsion. J Ultrasound Med. 23(12):1643-9; quiz 1650-1, 2004
- Hurh PJ et al: Ultrasound of a torsed ovary: characteristic gray-scale appearance despite normal arterial and venous flow on Doppler. Pediatr Radiol. 32(8):586-8, 2002
- Rha SE et al: CT and MR imaging features of adnexal torsion. Radiographics. 22(2):283-94, 2002
