Vorhersage der Adnextorsion mittels Ultraschalls bei Frauen mit akuten Unterbauchschmerzen

Translated title of the contribution: Prediction of Adnexal Torsion by Ultrasound in Women with Acute Abdominal Pain

Ron Bardin, Noga Perl, Reuven Mashiach, Eitan Ram, Sharon Orbach-Zinger, Anat Shmueli, Arnon Wiznitzer, Eran Hadar

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To investigate the accuracy of ultrasound in the diagnosis of adnexal torsion. Materials and Methods Retrospective cohort analysis of 322 women, presenting to a tertiary medical center with acute abdominal pain, who underwent gynecological examination, sonographic evaluation and laparoscopic surgery, between 2010 and 2016. Findings for adnexal torsion were compared among three groups: positive sonographic findings consistent with surgically confirmed adnexal torsion (true positive, n=228); negative sonographic findings inconsistent with surgically confirmed adnexal torsion (false negative, n=42); and positive sonographic findings inconsistent with a surgical diagnosis other than adnexal torsion (false positive, n=52). Outcome measures were sensitivity and positive predictive value of ultrasound, and its specific features, for the diagnosis of adnexal torsion. Results The sensitivity of ultrasound for adnexal torsion diagnosis was 84.4%, and the positive predictive value was 81.4%. Edematous ovary and/or tube, as well as positive whirlpool sign had the highest sensitivity and positive predictive value. The false-negative group had the highest frequency of ovarian cysts (p=0.0086) and the lowest frequency of ovarian edema (p <0.0001). The false-positive group had the lowest proportion of pregnant women (p=0.0022). Significantly more women in the true-positive group had a prior event of adnexal torsion (p=0.026). Conclusion Ultrasound examination is highly accurate in the diagnosis of adnexal torsion. Clinicians should be aware of the presence of demographic and clinical characteristics that may positively or negatively affect sonographic diagnostic accuracy.

Translated title of the contributionPrediction of Adnexal Torsion by Ultrasound in Women with Acute Abdominal Pain
Original languageGerman
Pages (from-to)688-694
Number of pages7
JournalUltraschall in der Medizin
Volume41
Issue number6
DOIs
StatePublished - 1 Dec 2020
Externally publishedYes

Keywords

  • adnexa
  • ovary
  • prediction
  • torsion
  • ultrasound

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