The Value of Computed Tomography in the Diagnosis of Adnexal Torsion

Abstract

Objective: To determine the diagnostic value of computed tomography (CT) in detecting adnexal torsion.
Methods: A retrospective, case-control study was conducted, including 110 surgical cases involving the adnexa, among which 55 cases were confirmed to have adnexal torsion. CT imaging findings
were recorded and analyzed using the Chi-square test, receiver operating characteristic (ROC) curve analysis, and multivariate logistic regression to assess diagnostic value and develop a diagnostic model for adnexal torsion.
Results: Adnexal torsion predominantly occurred in patients under 50 years old and was more frequently found on the right side. Malignant histopathological results accounted for approximately 8,9%. The CT
features associated with adnexal torsion included eccentric wall thickening, whirlpool sign, mass sign, navel sign, crescent sign, hemorrhage, uterine deviation, and non-enhancing tissue (p < 0,05). Among these, the whirlpool sign showed the highest specificity and positive predictive value in diagnosing adnexal torsion (96,4% and 93,6%, respectively). The diagnostic model for adnexal torsion based on four key features –whirlpool sign, mass sign, non-enhancing tissue, and navel sign – demonstrated good performance, with an area under the curve (AUC) of 0,88, sensitivity of 83,6%, and specificity of 89,3%.
Conclusion: CT is a valuable imaging modality for diagnosing adnexal torsion. The diagnostic model based on four key features –whirlpool sign, mass sign, non-enhancing tissue, and pedicle sign –
provides significant support in diagnosing the condition.