Korean J Radiol.  2015 Aug;16(4):835-845. 10.3348/kjr.2015.16.4.835.

Added Value of Using a CT Coronal Reformation to Diagnose Adnexal Torsion

Affiliations
  • 1Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.
  • 2Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul 158-710, Korea. ogjeong@ewha.ac.kr

Abstract


OBJECTIVE
To evaluate the increased value of using coronal reformation of a transverse computed tomography (CT) scan for detecting adnexal torsion.
MATERIALS AND METHODS
This study included 106 woman suspected of having adnexal torsion who underwent CT with coronal reformations and subsequent surgical exploration. Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan. The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance.
RESULTS
Fifty-two patients were confirmed to have adnexal torsion. The addition of coronal reformations to the transverse scan improved AUCs for readers 1 and 2 from 0.74 and 0.75 to 0.92 and 0.87, respectively, for detecting adnexal torsion (p < 0.001 and p = 0.004, respectively). Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively).
CONCLUSION
Use of a coronal reformation with transverse CT images improves detection of adnexal torsion.

Keyword

CT; Adnexa; Torsion

MeSH Terms

Acute Pain/diagnosis/radiography
Adnexa Uteri/pathology/*radiography
Adnexal Diseases/*radiography
Adolescent
Adult
Aged
Aged, 80 and over
Area Under Curve
Child
Female
Humans
Middle Aged
Pelvis/radiography
ROC Curve
Retrospective Studies
Tomography, X-Ray Computed/*methods
Torsion Abnormality/*diagnosis/*radiography
Young Adult
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