Spontaneous detorsion of the ovary: can it be diagnosed by MRI?
OBJECTIVE
To determine whether recent progress in imaging has made it possible to diagnose spontaneous detorsion, which is an accepted concept in the gynecological literature but until now has been a presumptive diagnosis that could not be confirmed because of the lack of imaging proof.


METHODS
We searched for patients who had a diagnosis of spontaneous detorsion on MRI between January 2000 and January 2003, and selected only patients who met a selection of strict criteria, including mainly enlargement and hyperintensity of ovarian stroma on T2-weighted (T2W) images, clinical findings compatible with torsion and detorsion, and return of the stroma to normal size on follow-up examinations. Other signs of torsion, such as tubal thickening, were appreciated but not mandatory. Clinical follow-up for at least three years was available.


RESULTS
Four patients met the study criteria. No stabilizing procedure was performed in the ovaries. One patient recurred and lost her ovary.


CONCLUSIONS
The diagnosis of torsion followed by spontaneous detorsion was made with high probability in a selected number of patients. The clinical management of such patients remains a matter of debate. Laparoscopy with oophoropexy would be useful for young patients in whom close follow-up cannot be achieved.
Ghossain
Michel A
MA
Department of Radiology, Hôtel Dieu de France, Beirut, Lebanon. ghossain@cyberia.net.lb
Hachem
Kamal
K
Aoun
Noël J
NJ
Haddad-Zebouni
Soha
S
Mansour
Fersan
F
Suidan
Joseph S
JS
Abboud
Joseph
J
D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010049:Ovarian Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012189:Retrospective Studies; D014102:Torsion Abnormality / Q000175:diagnosis; D014463:Ultrasonography