Skip to main content
Top
Published in: Pediatric Radiology 12/2015

01-11-2015 | Pictorial Essay

Pediatric ovarian torsion: a pictorial review

Authors: Anh-Vu Ngo, Jeffrey P. Otjen, Marguerite T. Parisi, Mark R. Ferguson, Randolph K. Otto, A. Luana Stanescu

Published in: Pediatric Radiology | Issue 12/2015

Login to get access

Abstract

Imaging is crucial in expediting the diagnosis and guiding definitive therapy in children with ovarian torsion. This article reviews the multimodality spectrum of imaging findings in pediatric ovarian torsion, focusing primarily on US appearances. We describe predisposing conditions that can lead to torsion, the pathological basis of the radiologic findings in ovarian torsion, and the common diagnostic pitfalls.
Literature
1.
go back to reference Servaes S, Zurakowski D, Laufer MR et al (2007) Sonographic findings of ovarian torsion in children. Pediatr Radiol 37:446–451CrossRefPubMed Servaes S, Zurakowski D, Laufer MR et al (2007) Sonographic findings of ovarian torsion in children. Pediatr Radiol 37:446–451CrossRefPubMed
2.
go back to reference Oltmann SC, Fischer A, Barber R et al (2009) Cannot exclude torsion — a 15-year review. J Pediatr Surg 44:1212–1216, discussion 1217CrossRefPubMed Oltmann SC, Fischer A, Barber R et al (2009) Cannot exclude torsion — a 15-year review. J Pediatr Surg 44:1212–1216, discussion 1217CrossRefPubMed
3.
go back to reference Chang HC, Bhatt S, Dogra VS (2008) Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics 28:1355–1368CrossRefPubMed Chang HC, Bhatt S, Dogra VS (2008) Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics 28:1355–1368CrossRefPubMed
5.
go back to reference Rha SE, Byun JY, Jung SE et al (2002) CT and MR imaging features of adnexal torsion. Radiographics 22:283–294CrossRefPubMed Rha SE, Byun JY, Jung SE et al (2002) CT and MR imaging features of adnexal torsion. Radiographics 22:283–294CrossRefPubMed
7.
go back to reference Oltmann SC, Fischer A, Barber R et al (2010) Pediatric ovarian malignancy presenting as ovarian torsion: incidence and relevance. J Pediatr Surg 45:135–139CrossRefPubMed Oltmann SC, Fischer A, Barber R et al (2010) Pediatric ovarian malignancy presenting as ovarian torsion: incidence and relevance. J Pediatr Surg 45:135–139CrossRefPubMed
8.
go back to reference Sommerville M, Grimes DA, Koonings PP et al (1991) Ovarian neoplasms and the risk of adnexal torsion. Am J Obstet Gynecol 164:577–578CrossRefPubMed Sommerville M, Grimes DA, Koonings PP et al (1991) Ovarian neoplasms and the risk of adnexal torsion. Am J Obstet Gynecol 164:577–578CrossRefPubMed
9.
go back to reference Davis AJ, Feins NR (1990) Subsequent asynchronous torsion of normal adnexa in children. J Pediatr Surg 25:687–689CrossRefPubMed Davis AJ, Feins NR (1990) Subsequent asynchronous torsion of normal adnexa in children. J Pediatr Surg 25:687–689CrossRefPubMed
10.
go back to reference Chinchure D, Ong CL, Loh AH et al (2011) Neonatal ovarian cysts: role of sonography in diagnosing torsion. Ann Acad Med Singapore 40:291–295PubMed Chinchure D, Ong CL, Loh AH et al (2011) Neonatal ovarian cysts: role of sonography in diagnosing torsion. Ann Acad Med Singapore 40:291–295PubMed
11.
go back to reference Crombleholme TM, Craigo SD, Garmel S et al (1997) Fetal ovarian cyst decompression to prevent torsion. J Pediatr Surg 32:1447–1449CrossRefPubMed Crombleholme TM, Craigo SD, Garmel S et al (1997) Fetal ovarian cyst decompression to prevent torsion. J Pediatr Surg 32:1447–1449CrossRefPubMed
12.
go back to reference Nussbaum AR, Sanders RC, Hartman DS et al (1988) Neonatal ovarian cysts: sonographic-pathologic correlation. Radiology 168:817–821CrossRefPubMed Nussbaum AR, Sanders RC, Hartman DS et al (1988) Neonatal ovarian cysts: sonographic-pathologic correlation. Radiology 168:817–821CrossRefPubMed
13.
go back to reference Mneimneh WS, Nazeer T, Jennings TA (2013) Torsion of the gonad in the pediatric population: spectrum of histologic findings with focus on aspects specific to neonates and infants. Pediatr Dev Pathol 16:74–79CrossRefPubMed Mneimneh WS, Nazeer T, Jennings TA (2013) Torsion of the gonad in the pediatric population: spectrum of histologic findings with focus on aspects specific to neonates and infants. Pediatr Dev Pathol 16:74–79CrossRefPubMed
14.
go back to reference Oelsner G, Cohen SB, Soriano D et al (2003) Minimal surgery for the twisted ischaemic adnexa can preserve ovarian function. Hum Reprod 18:2599–2602CrossRefPubMed Oelsner G, Cohen SB, Soriano D et al (2003) Minimal surgery for the twisted ischaemic adnexa can preserve ovarian function. Hum Reprod 18:2599–2602CrossRefPubMed
15.
go back to reference Geimanaite L, Trainavicius K (2013) Ovarian torsion in children: management and outcomes. J Pediatr Surg 48:1946–1953CrossRefPubMed Geimanaite L, Trainavicius K (2013) Ovarian torsion in children: management and outcomes. J Pediatr Surg 48:1946–1953CrossRefPubMed
16.
go back to reference McGovern PG, Noah R, Koenigsberg R et al (1999) Adnexal torsion and pulmonary embolism: case report and review of the literature. Obstet Gynecol Surv 54:601–608CrossRefPubMed McGovern PG, Noah R, Koenigsberg R et al (1999) Adnexal torsion and pulmonary embolism: case report and review of the literature. Obstet Gynecol Surv 54:601–608CrossRefPubMed
17.
go back to reference Albayram F, Hamper UM (2001) Ovarian and adnexal torsion: spectrum of sonographic findings with pathologic correlation. J Ultrasound Med 20:1083–1089PubMed Albayram F, Hamper UM (2001) Ovarian and adnexal torsion: spectrum of sonographic findings with pathologic correlation. J Ultrasound Med 20:1083–1089PubMed
18.
go back to reference Duigenan S, Oliva E, Lee SI (2012) Ovarian torsion: diagnostic features on CT and MRI with pathologic correlation. AJR Am J Roentgenol 198:W122–W131CrossRefPubMed Duigenan S, Oliva E, Lee SI (2012) Ovarian torsion: diagnostic features on CT and MRI with pathologic correlation. AJR Am J Roentgenol 198:W122–W131CrossRefPubMed
19.
go back to reference Linam LE, Darolia R, Naffaa LN et al (2007) US findings of adnexal torsion in children and adolescents: size really does matter. Pediatr Radiol 37:1013–1019CrossRefPubMed Linam LE, Darolia R, Naffaa LN et al (2007) US findings of adnexal torsion in children and adolescents: size really does matter. Pediatr Radiol 37:1013–1019CrossRefPubMed
21.
go back to reference Graif M, Itzchak Y (1988) Sonographic evaluation of ovarian torsion in childhood and adolescence. AJR Am J Roentgenol 150:647–649CrossRefPubMed Graif M, Itzchak Y (1988) Sonographic evaluation of ovarian torsion in childhood and adolescence. AJR Am J Roentgenol 150:647–649CrossRefPubMed
22.
go back to reference Fleischer AC, Stein SM, Cullinan JA et al (1995) Color Doppler sonography of adnexal torsion. J Ultrasound Med 14:523–528PubMed Fleischer AC, Stein SM, Cullinan JA et al (1995) Color Doppler sonography of adnexal torsion. J Ultrasound Med 14:523–528PubMed
23.
go back to reference Lee EJ, Kwon HC, Joo HJ et al (1998) Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J Ultrasound Med 17:83–89PubMed Lee EJ, Kwon HC, Joo HJ et al (1998) Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J Ultrasound Med 17:83–89PubMed
24.
go back to reference Valsky DV, Esh-Broder E, Cohen SM et al (2010) Added value of the gray-scale whirlpool sign in the diagnosis of adnexal torsion. Ultrasound Obstet Gynecol 36:630–634CrossRefPubMed Valsky DV, Esh-Broder E, Cohen SM et al (2010) Added value of the gray-scale whirlpool sign in the diagnosis of adnexal torsion. Ultrasound Obstet Gynecol 36:630–634CrossRefPubMed
25.
go back to reference Ledesma-Medina J, Towbin RB, Newman B (1992) Pediatric case of the day. Right ovarian torsion, amputation, and calcification. Radiographics 12:199–200CrossRefPubMed Ledesma-Medina J, Towbin RB, Newman B (1992) Pediatric case of the day. Right ovarian torsion, amputation, and calcification. Radiographics 12:199–200CrossRefPubMed
26.
go back to reference Hiller N, Appelbaum L, Simanovsky N et al (2007) CT features of adnexal torsion. AJR Am J Roentgenol 189:124–129CrossRefPubMed Hiller N, Appelbaum L, Simanovsky N et al (2007) CT features of adnexal torsion. AJR Am J Roentgenol 189:124–129CrossRefPubMed
27.
go back to reference Hurh PJ, Meyer JS, Shaaban A (2002) Ultrasound of a torsed ovary: characteristic gray-scale appearance despite normal arterial and venous flow on Doppler. Pediatr Radiol 32:586–588CrossRefPubMed Hurh PJ, Meyer JS, Shaaban A (2002) Ultrasound of a torsed ovary: characteristic gray-scale appearance despite normal arterial and venous flow on Doppler. Pediatr Radiol 32:586–588CrossRefPubMed
28.
go back to reference Kayaba H, Tamura H, Shirayama K et al (1996) Hemorrhagic ovarian cyst in childhood: a case report. J Pediatr Surg 31:978–979CrossRefPubMed Kayaba H, Tamura H, Shirayama K et al (1996) Hemorrhagic ovarian cyst in childhood: a case report. J Pediatr Surg 31:978–979CrossRefPubMed
29.
go back to reference Jain KA (2002) Sonographic spectrum of hemorrhagic ovarian cysts. J Ultrasound Med 21:879–886PubMed Jain KA (2002) Sonographic spectrum of hemorrhagic ovarian cysts. J Ultrasound Med 21:879–886PubMed
30.
go back to reference Orazi C, Inserra A, Lucchetti MC et al (2006) Isolated tubal torsion: a rare cause of pelvic pain at menarche. Sonographic and MR findings. Pediatr Radiol 36:1316–1318CrossRefPubMed Orazi C, Inserra A, Lucchetti MC et al (2006) Isolated tubal torsion: a rare cause of pelvic pain at menarche. Sonographic and MR findings. Pediatr Radiol 36:1316–1318CrossRefPubMed
31.
go back to reference Harmon JC, Binkovitz LA, Binkovitz LE (2008) Isolated fallopian tube torsion: sonographic and CT features. Pediatr Radiol 38:175–179CrossRefPubMed Harmon JC, Binkovitz LA, Binkovitz LE (2008) Isolated fallopian tube torsion: sonographic and CT features. Pediatr Radiol 38:175–179CrossRefPubMed
32.
go back to reference Narayanan S, Bandarkar A, Bulas DI (2014) Fallopian tube torsion in the pediatric age group: radiologic evaluation. J Ultrasound Med 33:1697–1704CrossRefPubMed Narayanan S, Bandarkar A, Bulas DI (2014) Fallopian tube torsion in the pediatric age group: radiologic evaluation. J Ultrasound Med 33:1697–1704CrossRefPubMed
33.
go back to reference Boukaidi SA, Delotte J, Steyaert H et al (2011) Thirteen cases of isolated tubal torsions associated with hydrosalpinx in children and adolescents, proposal for conservative management: retrospective review and literature survey. J Pediatr Surg 46:1425–1431CrossRefPubMed Boukaidi SA, Delotte J, Steyaert H et al (2011) Thirteen cases of isolated tubal torsions associated with hydrosalpinx in children and adolescents, proposal for conservative management: retrospective review and literature survey. J Pediatr Surg 46:1425–1431CrossRefPubMed
34.
go back to reference Garel L, Dubois J, Grignon A et al (2001) US of the pediatric female pelvis: a clinical perspective. Radiographics 21:1393–1407CrossRefPubMed Garel L, Dubois J, Grignon A et al (2001) US of the pediatric female pelvis: a clinical perspective. Radiographics 21:1393–1407CrossRefPubMed
Metadata
Title
Pediatric ovarian torsion: a pictorial review
Authors
Anh-Vu Ngo
Jeffrey P. Otjen
Marguerite T. Parisi
Mark R. Ferguson
Randolph K. Otto
A. Luana Stanescu
Publication date
01-11-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 12/2015
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-015-3385-x

Other articles of this Issue 12/2015

Pediatric Radiology 12/2015 Go to the issue