Presentation
One week history of severe pelvic pain.
Patient Data
The right ovary is diffusely enlarged (8.6 x 5.2 x 4.6 cm) hypoechoic with no venous or arterial flow seen within on color Doppler. The whirlpool sign is well-visualized on color Doppler.
The MRI sequences demonstrate an enlarged right ovary of intermediate signal on T1, inhomogeneous high signal on T2 with multiple small peripheral follicles of high signal on T1/T1 fat sat in keeping with hemorrhagic follicles. The postcontrast sequences show a moderate peripheral enhancement (infarcted ovary). The twisted right ovarian pedicle (whirlpool sign or whirl sign) is well-visualized on T2 and postcontrast sequences. Moderate peritoneal effusion. Mild intraperitoneal effusion.
The left ovary shows a normal appearance with small follicles.
Normal appearance of the uterus
Case Discussion
MRI features of an ovarian torsion which was confirmed at surgery.