CT Feature and Clinical Analysis of Adnexal Torsion in Children
- VernacularTitle:儿童附件扭转的CT特征与临床对照分析
- Author:
Lian-wei LU
1
;
Hui-ying WU
1
;
Qiang LIU
1
;
Xi-wen CHEN
1
;
Rui WANG
1
;
Yu-tao LIU
1
Author Information
1. Department of Medical Imaging， Guangzhou Women and Children’s Medical Center，Guangzhou 510623， China
- Publication Type:Journal Article
- Keywords:
adnexal;
torsion;
computed tomography;
children
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(1):124-132
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo analyze the CT findings and clinical features of adnexal torsion （AT） in children， so as to improve the diagnostic accuracy. MethodsWe retrospectively studied the clinical data and CT images of 26 patients （27 lesions） with surgically and pathologically proven pediatric AT. The CT findings and pathological features were summarized. The positive rates of imaging signs were examined. ResultsIn 26 patients （age range， 1 day-12 years； mean， 5.5 years）， 20 complained of lower abdominal pain and 6 were asymptomatic. Fifteen torsions occurred on the right side， ten on the left side and one at both sides. Among the 27 lesions， 25 were complete torsions and 2 partial torsions； 19 were combined with space-occupying lesions and 8 isolated AT. Ranging from 3.4 cm to 14.0 cm， with an average of 5.9 cm， 12 lesions displayed enlarged ovaries on the affected side， 14 calcification and 20 small peripherally cystic structures with 4~12 mm. Contrast-enhanced scan revealed mild enhancement in 26 lesions （<20 HU）. 11 lesions presented with whirlpool sign， 12 with uterine deviation to the twisted side， 7 with ascites and 11 with blurred fat space around the pelvic cavity. The diagnostic accuracy of CT was 88.9%. ConclusionsFetal ovarian cyst with cyst-wall calcification is suggestive of AT. Teratoma and ovarian cysts are risk factors for AT in children. Asymmetrically enlarged ovaries and small peripheral cysts are highly specific CT features of AT. The pediatric AT should be highly suspected in patients with additional imaging findings such as whirlpool sign， uterine deviation to the twisted side， ascites， fuzziness of pelvic fat space， and teratoma （cyst） wall thickening.
