title: Added Value of Using a CT Coronal Reformation to Diagnose Adnexal Torsion.
abstract: OBJECTIVE
  To evaluate the increased value of using coronal reformation of a transverse computed tomography (CT) scan for detecting adnexal torsion.
  
  
  METHODS
  This study included 106 woman suspected of having adnexal torsion who underwent CT with coronal reformations and subsequent surgical exploration. Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan. The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance.
  
  
  RESULTS
  Fifty-two patients were confirmed to have adnexal torsion. The addition of coronal reformations to the transverse scan improved AUCs for readers 1 and 2 from 0.74 and 0.75 to 0.92 and 0.87, respectively, for detecting adnexal torsion (p < 0.001 and p = 0.004, respectively). Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively).
  
  
  CONCLUSIONS
  Use of a coronal reformation with transverse CT images improves detection of adnexal torsion.
authors.affiliation: Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Jung
authors.affiliation: Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.
authors.forename: Hee Sun
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.
authors.forename: Younghee
authors.initials: Y
authors.lastname: Yim
authors.affiliation: Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.
authors.forename: Hae Jeong
authors.initials: HJ
authors.lastname: Jeon
authors.affiliation: Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.
authors.forename: Mi Hye
authors.initials: MH
authors.lastname: Yu
authors.affiliation: Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul 158-710, Korea.
authors.forename: Kyungah
authors.initials: K
authors.lastname: Jeong
mesh_terms: D059787:Acute Pain / Q000175:diagnosis / Q000000981:diagnostic imaging; D000290:Adnexa Uteri / Q000000981:diagnostic imaging* / Q000473:pathology; D000291:Adnexal Diseases / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D002648:Child; D005260:Female; D006801:Humans; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014102:Torsion Abnormality / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Adnexa; CT; Torsion