How accurate is CT scanning for diagnosing ovarian torsion?

Updated: Jun 27, 2017
  • Author: Erik D Schraga, MD; Chief Editor: Eugene C Lin, MD  more...
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Answer

In a study by Moore et al, before undergoing surgery for ovarian torsion, 28 of 28 patients had had CT confirmation of an enlarged ovary, ovarian cyst, or adnexal mass of the involved ovary [33] ; the authors therefore concluded that ovarian torsion can be ruled out by well-visualized normal-appearing ovaries on CT and that either abnormal findings or inability to visualize the ovaries on CT necessitates further evaluation for possible ovarian torsion.

Although CT may demonstrate an enlarged ovary and adnexal masses, it is unable to evaluate the presence or absence of blood flow to the involved ovary. In cases of diagnostic uncertainty, however, CT may be useful in ruling out other possible causes of lower abdominal pain. [34] Additionally, CT can exclude the presence of a pelvic mass, thereby greatly enhancing the clinician’s ability to rule out torsion.

In a study of women who presented to the ED and were evaluated for ovarian torsion, the negative predictive value of a negative CT examination was 100%. It was also found that color Doppler ultrasound offered no utility in evaluating for ovarian torsion after a negative contrast-enhanced CT scan of the abdomen and pelvis. [35]


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