Diagnostic Efficacy of Sonography for Diagnosis of Ovarian Torsion

Objectives: Misdiagnosing ovarian torsion is now suggested as an important issue in clinical setting. The aim of this study was to determine the diagnostic accuracy of sonography for ovarian torsion.

Methods: In this study 323 women with acute pelvic pain with highly suspected ovarian torsion signs and symptoms attending Imam Reza Medical Center in Kermanshah between 2011 through 2012 were included and underwent a transabdominal sonography (2-5 MHz probes). Then findings of sonography were compared with laparatomy.

Results: The ultrasound correctly diagnosed 72.1% of ovarian torsion and missed 27.9% of them (false negatives). However, one free subject (0.4%) was misclassified as ovarian torsion (false positive). There was a strong correlation between sonography and laparatomy with a kappa value of 84.0%. The sensitivity and specificity of sonography were 72.1% and 99.6%, respectively. Sonography had a positive predictive value of 96.9%, a negative predictive value of 95.9%, and a total accuracy of 96.0% for detection of ovarian torsion.

Conclusion: Sonography appears to be an excellent method to evaluate patients with suspected ovarian torsion. Abnormal blood flow detected by sonography is highly predictive of ovarian torsion and is therefore useful in the diagnosis of this phenomenon.