Ultrasonography and Magnetic Resonance Imaging in Ovarian Torsion - A Retrospective Study in Hoskote

Author(s): Vinjamuri Anuradha1, Prashanth Venkateswaran2, Manasa Pandith P.C.3, Puneet Shirbur4

Ovarian torsion occurs when the ovary twists on its fibrovascular pedicle resulting
in vascular compromise. Initially, there is twisting of the ovary, fallopian tube, or
both structures, causing venous, lymphatic and arterial compromise with resultant
ovarian oedema and adnexal enlargement. We wanted to determine the most
common ultrasonography (USG) and magnetic resonance imaging (MRI) findings
in surgically proven cases of ovarian torsion.
We present a series of cases obtained on retrospective review of USG and MRI
findings in 10 surgically proven cases of ovarian torsion between June 2018 to
June 2020 in the Department of Radiology, MVJ Medical College & Research
Hospital, Hoskote.
Significant enlargement of the ovary with size ranging from 5 to 15 cms with
peripherally displaced follicles and free fluid in the pelvis in noted in all the patients
on USG and MRI. Other common MRI features include ‘twisted vascular pedicle’
sign seen in 7 (70 %) cases, areas of haemorrhage within the ovarian stroma in 7
(70 %) cases and abnormal ovarian enhancement in 9 (90 %) cases.
Ultrasound and MRI are the main diagnostic imaging modalities prior to treatment.
Improved detection and characterisation of pelvic mass contributes to better
diagnostic accuracy. The most common findings in US and MRI features of ovarian
torsion include ovarian enlargement with peripherally displaced follicles and free
fluid in pelvis. Other common MRI features include ovarian haemorrhage, twisted
vascular pedicle, abnormal ovarian enhancement and deviation of the uterus
towards the same side.