Case Review: Ultrasound of Ovarian Torsion - a podcast by Daniel J. Kowal, MD

In this radiology lecture, we discuss the ultrasound appearance of ovarian torsion.

Key points include:



* Rotation of ovarian vascular pedicle with obstruction to venous outflow and arterial inflow.

* Enlarged, heterogenous ovary due to hemorrhage and edema.

* Small peripheral cysts with “follicular ring” sign: Thick, hyperechoic rim surrounding follicles of torsed ovary.

* Classically, absent vascular flow.

* However, up to 60% of patients with torsion have normal color Doppler findings, and arterial flow may even be preserved!

* Most common finding is decreased or absent venous flow.

* Twisted vascular pedicle: Most definitive sign of torsion, present in up to 88% of patients.

* “Whirlpool” sign: Flow within the twisted vascular pedicle.



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