Tubo-ovarian torsion

Case contributed by Ammar Haouimi


One week history of severe right lower abdominal pain.

Patient Data

Age: 50 years
Gender: Female

The right ovary is enlarged hypoechoic (edematous)  with a central hyperechoic stroma, and peripheral displacement of the follicles. No arterial or venous flow seen within the ovary on color Doppler. 

The left ovary (not shown) was small in size with normal appearance.


Enlarged right ovary (11 x 7 x 5.5 cm) and fallopian tube with peripherally displaced cysts and follicles (diametre up to 3.5 cm). It displays an intermediate signal on T1, low signal on T2 with a peripheral rim of enhancement. Some of the cysts and follicles show high signal on T1 fat sat with low signal sediment (hemorrhage). The twisted pedicle is well-visualized on T2 sequences.

Minimal effusion is seen in Douglas pouch.

The left ovary is normal in appearance.

Case Discussion

The ultrasound and MRI features are most consistent with a tubo-ovarian torsion which was confirmed at the surgery and the patient had a right adnexectomy and ovariectomy.


Additional contributor: C. Boukaaba, MD

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