Validity of Ultrasound in Patients with Acute Pelvic Pain Related to Suspected Ovarian Torsion

作     者：Leena Mawaldi Charu Gupta Hanadi Bakhsh Maissa Saadeh Mostafa A. Abolfotouh 

作者机构：King Abdullah International Medical Research Center (KAIMRC) King Saud Bin-Abdulaziz University for 

出 版 物：《Surgical Science》 (外科学（英文）)

年 卷 期：2011年第2卷第6期

页      面：326-330页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Acute Pelvic Pain Ultrasound Ovarian Torsion 

摘      要：Objective: Ultrasound has been proven to be useful in detecting underlying ovarian pathology. However, its role in the prediction of ovarian torsion has been controversial. The aim of the study was to assess the validity of ultrasound in the prediction of ovarian torsion in patients with acute pelvic pain related to clinically suspected ovarian torsion. Methods: A retrospective observational study was conducted at the Ob/Gyn department using a 10-year chart review of all female patients older than 11 years of age with highly suspected ovarian torsion who underwent clinical assessment and ultrasound prior to surgery (n = 62). The sensitivity and specificity of ultrasound were determined by cross-tabulation of the ultrasound and surgical findings. Results: Of the suspected cases, 54 (87.1%) were confirmed to be cases of ovarian torsion by surgery. The majority of the cases were suggestive of ovarian torsion, which was indicated by clinical examination (77.4%), ultrasound (77.4%), or pathological examination (79%). Almost one-half of the cases (46.8%) showed a pain score 6;two-thirds (62.9%) presented with vomiting and/or nausea;and more than one-third (38.7%) presented with leukocytosis. The estimated sensitivity and specificity of ultrasound were 0.74 and 0.0, respectively. The positive predictive value was 0.83. Ultrasound was significantly associated with both clinical examination (p = 0.039) and pain score (p = 0.008). Conclusion: The diagnosis of ovarian torsion cannot be exclusively based on ultrasound. Both clinical and sonographical evaluation of acute pelvic pain should be considered for the diagnosis. A definitive diagnosis remains challenging.