Added Value of Using a CT Coronal Reformation to Diagnose Adnexal Torsion.
10.3348/kjr.2015.16.4.835
- Author:
Sung Il JUNG
1
;
Hee Sun PARK
;
Younghee YIM
;
Hae Jeong JEON
;
Mi Hye YU
;
Young Jun KIM
;
Kyungah JEONG
Author Information
1. Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.
- Publication Type:Evaluation Studies ; Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
CT;
Adnexa;
Torsion
- MeSH:
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
- From:Korean Journal of Radiology
2015;16(4):835-845
- CountryRepublic of Korea
- Language:English
-
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.
