Value of intra-adnexal and extra-adnexal computed tomographic imaging features diagnosing torsion of adnexal tumor.
OBJECTIVE
The objective of this study was to evaluate the usefulness of the intra-adnexal and extra-adnexal computed tomographic (CT) features in identifying adnexal torsion.


METHODS
We retrospectively analyzed CT examinations of 38 adnexal masses with torsion and 270 without torsion, which has been surgicopathologically confirmed. The CT features were evaluated according to 2 categorized groups. The first group included the intra-adnexal features dealing with the ovary and uterine tube, whereas the other included the extra-adnexal features dealing with changes of adjacent anatomical structures such as the uterus, gonadal vein, and peritumoral zone. We acquired statistical proportions for the frequencies of these 2 groups of CT features in ovarian tumors with adnexal torsion versus those without adnexal torsion.


RESULTS
When there were intra-adnexal CT features of adnexal torsion, peculiar uterine tube thickening was identified in 74% of the lesions, eccentric or concentric wall thickening in 54% (of only cystic lesions), eccentric septal thickening in 50% (of only cystic lesions except mature cystic teratoma), and eccentric or diffuse decreased or poor contrast enhancement of the internal solid component or thickened wall in 50%. In extra-adnexal CT features of adnexal torsion, uterine deviation to the twisted side was identified in 61% of the lesions, peritumoral infiltration in 40%, nonvisualized anatomic continuity of the ipsilateral gonadal vein with the twisted adnexal mass in 71%, and ascites in 13%. There were significant differences in all of the intra-adnexal and extra-adnexal CT findings, except for ascites, between twisted and nontwisted adnexal tumors.


CONCLUSIONS
The intra-adnexal and extra-adnexal groups of CT features are valuable in identifying torsion of adnexal mass.
Lee
Jong Hwa
JH
Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. jhlee@uuh.ulsan.kr
Park
Seong Bin
SB
Shin
Sang Hoon
SH
Jang
Jong Chang
JC
Lee
Won Chan
WC
Jeong
Ae Kyoung
AK
Yang
Myeon Jun
MJ
D000290:Adnexa Uteri / Q000000981:diagnostic imaging* / Q000473:pathology; D000291:Adnexal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*; D014102:Torsion Abnormality / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide