Ruptured Corpus Luteal Cyst: Prediction of Clinical Outcomes with CT.
10.3348/kjr.2017.18.4.607
- Author:
Myoung Seok LEE
1
;
Min Hoan MOON
;
Hyunsik WOO
;
Chang Kyu SUNG
;
Hye Won JEON
;
Taek Sang LEE
Author Information
1. Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea. mmhoan@gmail.com
- Publication Type:Original Article
- Keywords:
Computed tomography;
Ovarian cyst;
Corpus luteum cyst;
Ovary;
Hemoperitoneum
- MeSH:
Abdominal Pain;
Emergency Service, Hospital;
Female;
Fires;
Hemoperitoneum;
Hemorrhage;
Humans;
Logistic Models;
Odds Ratio;
Ovarian Cysts;
Ovary;
Retrospective Studies;
Rupture;
Sensitivity and Specificity;
Tomography, X-Ray Computed
- From:Korean Journal of Radiology
2017;18(4):607-614
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the determinant pretreatment CT findings that can predict surgical intervention for patients suffering from corpus luteal cyst rupture with hemoperitoneum. MATERIALS AND METHODS: From January 2009 to December 2014, a total of 106 female patients (mean age, 26.1 years; range, 17–44 years) who visited the emergency room of our institute for acute abdominal pain and were subsequently diagnosed with ruptured corpus luteal cyst with hemoperitoneum were included in the retrospective study. The analysis of CT findings included cyst size, cyst shape, sentinel clot sign, ring of fire sign, hemoperitoneum depth, active bleeding in portal phase and attenuation of hemoperitoneum. The comparison of CT findings between the surgery and conservative management groups was performed with the Mann-Whitney U test or chi-square test. Logistic regression analysis was used to determine significant CT findings in predicting surgical intervention for a ruptured cyst. RESULTS: Comparative analysis revealed that the presence of active bleeding and the hemoperitoneum depth were significantly different between the surgery and conservative management groups and were confirmed as significant CT findings for predicting surgery, with adjusted odds ratio (ORs) of 3.773 and 1.318, respectively (p < 0.01). On the receiver-operating characteristic curve analysis for hemoperitoneum depth, the optimal cut-off value was 5.8 cm with 73.7% sensitivity and 58.6% specificity (Az = 0.711, p = 0.004). In cases with a hemoperitoneum depth > 5.8 cm and concurrent active bleeding, the OR for surgery increased to 5.786. CONCLUSION: The presence of active bleeding and the hemoperitoneum depth on a pretreatment CT scan can be predictive warning signs of surgery for a patient with a ruptured corpus luteal cyst with hemoperitoneum.
