title: Fluid-debris level in follicular cysts: a pathognomonic sign of ovarian torsion.
abstract: BACKGROUND
  Early diagnosis of ovarian torsion is mandatory to avoid common complications. Sonography is the imaging modality of choice, but diagnosis is still a challenge.
  
  
  OBJECTIVE
  To report an additional sonographic feature of ovarian torsion in order to improve diagnostic accuracy.
  
  
  METHODS
  Grey-scale and colour Doppler pelvic sonography was performed in 12 patients with acute onset of intermittent lower abdominal pain and in 1 asymptomatic patient with a palpable mass in the labium majus. Patient ages ranged from 4 months to 17 years.
  
  
  RESULTS
  In all patients an enlarged ovary with peripheral cysts was demonstrated. High-resolution sonography detected fluid-debris levels within these cystic structures in 11 of the 13 patients (sensitivity 85%) and provided an additional diagnostic sign. Six patients had cystic teratoma.
  
  
  CONCLUSIONS
  We confirm the fluid-debris level as a pathognomonic sonographic sign of ovarian torsion with or without associated teratoma.
authors.affiliation: Clinical Division of Neonatology, Clinical Department of Paediatrics, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Ursula
authors.initials: U
authors.lastname: Kiechl-Kohlendorfer
authors.forename: Kathrin
authors.initials: K
authors.lastname: Maurer
authors.forename: Karin M
authors.initials: KM
authors.lastname: Unsinn
authors.forename: Ingmar
authors.initials: I
authors.lastname: Gassner
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005497:Follicular Cyst / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D010049:Ovarian Diseases / Q000000981:diagnostic imaging*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging* / Q000473:pathology; D014102:Torsion Abnormality / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color