Tubo-ovarian torsion

Case contributed by Dr Ammar Haouimi

Presentation

Severe left pelvic pain of 3 days duration

Patient Data

Age: 35 years
Gender: Female
MRI

The left ovary is enlarged (7.2x6.4x6.2 cm) as well as the ipsilateral fallopian tube (thickness=1.8 cm) of intermediate to low signal intensity on T1WI, low signal intensity on T2WI (probably due to an interstitial hemorrhage) with the high signal of the follicles which are displaced peripherally. Small corpus luteal cyst, as well as a hemorrhagic follicle, are noted within the ovary. The twisted pedicle is well-visualized on T2 sequences just cranial to the ovary. The postcontrast sequences demonstrate a peripheral enhancement with surrounding fat stranding and free fluid.

The right ovary is normal in appearance.

The uterus is of normal size and configuration with moderate diffuse thickening of the endometrial-myometrial junctional zone (~15 mm) of homogeneous low signal intensity on T2WI (adenomyosis)

 

Case Discussion

MRI features are most consistent with left sided tubo-ovarian torsion which was confirmed at surgery.

 

Additional contributor: C. Boukaaba, MD

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Case information

rID: 71096
Published: 18th Sep 2019
Last edited: 19th Sep 2019
System: Gynaecology
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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