Presentation
Intermittent pelvic pain mainly on the right.
Patient Data
Enlarged heterogeneous hypoechoic right ovary with no significant vascular flow on color Doppler.
The right ovary is enlarged (measuring 75 x 70 x 50 mm), located in the Douglas pouch of high signal peripherally on T1 (a rim of methemoglobin), high signal on T2 with small follicles mainly of peripheral distribution. No enhancement is seen on postcontrast sequences. Evidence of twisted ovarian pedicle well-visualized on all sequences.
Normal appearance of the left ovary containing numerous small follicles.
Normal size and shape of the uterus.
Case Discussion
Ultrasound and MRI features of an ovarian torsion that was confirmed at surgery.
Ovarian torsion, also known as adnexal torsion or tubo-ovarian torsion is defined as a rotation of the ovary and portion of the fallopian tube supplying the vascular pedicle.
Ovarian torsion occurs mainly in two situations:
- hypermobility of the ovary: <50%
- adnexal mass: 50-80%, most lesions are dermoid cysts or para ovarian cysts
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