Which study is used to predict viability of adnexal structures in ovarian torsion?

Updated: Jun 27, 2017
  • Author: Erik D Schraga, MD; Chief Editor: Eugene C Lin, MD  more...
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Color Doppler sonography may be helpful in predicting viability of adnexal structures by depicting blood flow within the twisted vascular pedicle and presence of central venous flow. [14] On color Doppler sonograms, little or no intraovarian venous flow is present; this finding is followed by a lack of intraovarian arterial flow. Flow within the adnexal vessels may be preserved (see the video below). [24]

Video depicts 2 findings: (1) enlarged hypovascular left ovary and (2) flow in healthy right ovary. Small amount of intraperitoneal fluid surrounds left ovary.

Occasionally, the twisted pedicle of the affected ovary can be recognized. A twisted pedicle is a relatively specific sign for ovarian torsion. With isolated tubal torsion, the tube is usually distended and lacks flow or has reversed flow during diastole. Because venous flow is under low pressure, it is the first flow to be affected by the increased interstitial pressure of a twisted ovary. In chronic torsion, arterial waveforms can mimic venous waveforms. When torsion is complete, no arterial waveforms can be detected within the ovary.

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