Highlights
- •Early and accurate diagnosis is crucial for preserving the viability of ovaries.
- •We recently noticed a unique MRI sign, seen as a hypointense dot on the pedicle of a torsed ovary.
- •T2-hypointense dot sign is a novel sign for the imaging-based diagnosis of ovarian torsion.
Abstract
Purpose
We aimed to describe “T2-hypointense dot sign” for the diagnosis of ovarian torsion
and compare its diagnostic capability with whirlpool sign.
Methods
Pelvic MRIs of 31 patients with surgically proven ovarian torsion were used for the
analysis. The control group was comprised of 30 patients with adnexal neoplasm and
15 patients with tubo-ovarian abscess. The MRIs of all 76 patients were retrospectively
evaluated by two independent radiologists for the presence of T2-hypointense dot sign
and whirlpool sign using a three-point scale.
Results
The sensitivity, specificity, positive predictive value, negative predictive value,
and accuracy values for the T2-hypointense dot sign for the diagnosis of ovarian torsion
for observer 1 and observer 2 were 0.90, 1, 1, 0.93, and 0.96 and 0.87, 1, 1, 0.91,
and 0.94, respectively. These same values for the whirlpool sign for observer 1 and
observer 2 were 0.58, 1, 1, 0.77, and 0.82 and 0.42, 1, 1, 0.71, and 0.76, respectively.
Both signs were definitely negative in patients with adnexal neoplasm and tubo-ovarian
abscess. Interobserver agreement was excellent for the T2-hypointense dot sign (κ = 0.83),
but poor for the whirlpool sign (κ = 0.31).
Conclusions
The presence of T2-hypointense dot sign could be a valuable clue for the accurate
and early diagnosis of ovarian torsion in non-contrast MRI scans.
Keywords
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Article info
Publication history
Published online: March 26, 2019
Accepted:
March 25,
2019
Received in revised form:
March 16,
2019
Received:
November 18,
2018
Footnotes
☆The authors have no commercial associations or sources of support that might pose a conflict of interest. All authors have made substantive contributions to the study, and all authors endorse the data and conclusions. Institutional review board approved the study.
☆☆“This study was presented orally at Turkish Society of Magnetic Resonance 23rd Annual Meeting.”
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
