Are Ultrasonographic Findings Suggestive of Ovarian Stromal Edema Associated with Ischemic Adnexal Torsion?
OBJECTIVE
To study whether sonographic findings suggestive of ovarian stromal edema are associated with tissue ischemia in patients with adnexal torsion.


METHODS
A study of 79 patients with adnexal torsion was performed. Patients were divided into an ischemic group, in which the twisted adnexa were seen as blue or black, and a non-ischemic group, in which the adnexa retained normal color and appeared viable. Clinical and ultrasonographic findings, specifically the presence of ultrasonographic signs suggestive of ovarian stromal edema, were compared between the two groups.


RESULTS
Of the 79 patients with torsion, in 44 (55.7%) the adnexa appeared ischemic at surgery. The presence of ischemia was not associated with age, pregnancy, duration of pain, vomiting or findings at physical examination. There was no significant difference between the ischemic and the non-ischemic group in the proportion of patients with signs of ovarian stromal edema (59 vs. 40%, p = 0.11), in the proportion of patients with absent/diminished stromal Doppler flow (36 vs. 28%, p = 0.12%) or in the proportion of patients with both signs of stroma edema and absent/diminished stromal Doppler flow (20 vs. 12%, p = 0.36).


CONCLUSIONS
Ultrasonographic signs of ovarian stromal edema do not assist in differentiating between ischemic and non-ischemic adnexal torsion.
Department of Obstetrics and Gynecology and Epidemiology Institute 1, Ben-Gurion University, Barzilai Medical Center, Ashkelon, Israel.
Odelia
O
Yaakov
Efraim
E
Zohav
Victoria
V
Kapustian
Michael
M
Gdalevich
Michael
M
Volodarsky
Eyal Y
EY
Anteby
Ofer
O
Gemer
D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D004487:Edema / Q000000981:diagnostic imaging*; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010049:Ovarian Diseases / Q000000981:diagnostic imaging*; D010053:Ovary / Q000098:blood supply*; D012189:Retrospective Studies; D014102:Torsion Abnormality / Q000150:complications / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult