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Added Value of Using a CT Coronal Reformation to Diagnose Adnexal Torsion.

Jung SI, Park HS, Yim Y, Jeon HJ, Yu MH, Kim YJ, Jeong K - Korean J Radiol (2015)

Bottom Line: Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan.The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance.Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.

ABSTRACT

Objective: To evaluate the increased value of using coronal reformation of a transverse computed tomography (CT) scan for detecting adnexal torsion.

Materials and methods: This study included 106 woman suspected of having adnexal torsion who underwent CT with coronal reformations and subsequent surgical exploration. Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan. The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance.

Results: Fifty-two patients were confirmed to have adnexal torsion. The addition of coronal reformations to the transverse scan improved AUCs for readers 1 and 2 from 0.74 and 0.75 to 0.92 and 0.87, respectively, for detecting adnexal torsion (p < 0.001 and p = 0.004, respectively). Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively).

Conclusion: Use of a coronal reformation with transverse CT images improves detection of adnexal torsion.

No MeSH data available.


Related in: MedlinePlus

Contrast-enhanced computed tomography (CT) scan of 52-year-old woman with torsion of follicular cyst in right ovary.Transverse CT scan (A) and coronal reformation (B) show eccentric septal thickening (arrow) of cystic mass.
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Figure 5: Contrast-enhanced computed tomography (CT) scan of 52-year-old woman with torsion of follicular cyst in right ovary.Transverse CT scan (A) and coronal reformation (B) show eccentric septal thickening (arrow) of cystic mass.

Mentions: Adding the coronal reformation to the transverse CT scan improved overall diagnostic performance for detecting adnexal torsion (Table 2, Fig. 1). The AUC for reader 1 increased from 0.74 (95% CI, 0.64-0.82) with a transverse CT scan alone to 0.92 (95% CI, 0.85-0.96) with a coronal reformation and a transverse CT scan (p < 0.001). The AUC for reader 2 increased from 0.75 (95% CI, 0.66-0.83) with a transverse CT scan alone to 0.87 (95% CI, 0.79-0.92) with a coronal reformation and a transverse CT scan (p = 0.004). Interreader agreement for detecting adnexal torsion was moderate (κ = 0.46 for a transverse CT scan alone and κ = 0.57 for a coronal reformation and a transverse CT scan). Sensitivity, specificity, PPV, and accuracy values of each CT finding for diagnosing adnexal torsion using a transverse CT scan alone and a coronal reformation and a transverse CT scan are presented for both readers in Tables 3 and 4 and Figures 2, 3, 4, 5, 6, 7. Sensitivity of reader 1 for the CT finding of a twisted adnexal pedicle increased significantly from 0.27 (95% CI, 0.17-0.40) with a transverse CT scan alone to 0.79 (95% CI, 0.66-0.88) with a coronal reformation and a transverse CT scan (p < 0.001), while sensitivity of reader 2 increased significantly from 0.29 (95% CI, 0.18-0.42) with a transverse CT scan alone to 0.77 (95% CI, 0.64-0.86) with a coronal reformation and a transverse CT scan (p < 0.001).


Added Value of Using a CT Coronal Reformation to Diagnose Adnexal Torsion.

Jung SI, Park HS, Yim Y, Jeon HJ, Yu MH, Kim YJ, Jeong K - Korean J Radiol (2015)

Contrast-enhanced computed tomography (CT) scan of 52-year-old woman with torsion of follicular cyst in right ovary.Transverse CT scan (A) and coronal reformation (B) show eccentric septal thickening (arrow) of cystic mass.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499548&req=5

Figure 5: Contrast-enhanced computed tomography (CT) scan of 52-year-old woman with torsion of follicular cyst in right ovary.Transverse CT scan (A) and coronal reformation (B) show eccentric septal thickening (arrow) of cystic mass.
Mentions: Adding the coronal reformation to the transverse CT scan improved overall diagnostic performance for detecting adnexal torsion (Table 2, Fig. 1). The AUC for reader 1 increased from 0.74 (95% CI, 0.64-0.82) with a transverse CT scan alone to 0.92 (95% CI, 0.85-0.96) with a coronal reformation and a transverse CT scan (p < 0.001). The AUC for reader 2 increased from 0.75 (95% CI, 0.66-0.83) with a transverse CT scan alone to 0.87 (95% CI, 0.79-0.92) with a coronal reformation and a transverse CT scan (p = 0.004). Interreader agreement for detecting adnexal torsion was moderate (κ = 0.46 for a transverse CT scan alone and κ = 0.57 for a coronal reformation and a transverse CT scan). Sensitivity, specificity, PPV, and accuracy values of each CT finding for diagnosing adnexal torsion using a transverse CT scan alone and a coronal reformation and a transverse CT scan are presented for both readers in Tables 3 and 4 and Figures 2, 3, 4, 5, 6, 7. Sensitivity of reader 1 for the CT finding of a twisted adnexal pedicle increased significantly from 0.27 (95% CI, 0.17-0.40) with a transverse CT scan alone to 0.79 (95% CI, 0.66-0.88) with a coronal reformation and a transverse CT scan (p < 0.001), while sensitivity of reader 2 increased significantly from 0.29 (95% CI, 0.18-0.42) with a transverse CT scan alone to 0.77 (95% CI, 0.64-0.86) with a coronal reformation and a transverse CT scan (p < 0.001).

Bottom Line: Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan.The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance.Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Konkuk University School of Medicine, Research Institute of Medical Science, Seoul 143-729, Korea.

ABSTRACT

Objective: To evaluate the increased value of using coronal reformation of a transverse computed tomography (CT) scan for detecting adnexal torsion.

Materials and methods: This study included 106 woman suspected of having adnexal torsion who underwent CT with coronal reformations and subsequent surgical exploration. Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan. The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance.

Results: Fifty-two patients were confirmed to have adnexal torsion. The addition of coronal reformations to the transverse scan improved AUCs for readers 1 and 2 from 0.74 and 0.75 to 0.92 and 0.87, respectively, for detecting adnexal torsion (p < 0.001 and p = 0.004, respectively). Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively).

Conclusion: Use of a coronal reformation with transverse CT images improves detection of adnexal torsion.

No MeSH data available.


Related in: MedlinePlus