CT predictive model for torsion angle as a marker for risk of necrosis in patients with adnexal torsion. Issue 7 (July 2021)

• Record Type: Journal Article
• Authors: Duan, N.; Chen, X.; Rao, M.; Zhou, C.; Wang, Z.
• Is Part Of: Clinical radiology. Volume 76:Issue 7(2021)
• Page Start: 540
• Page End: 546
• Publication Date: 2021-07
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2021.02.027
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : AIM: To assess the feasibility of preoperative computed tomography (CT) prediction of torsion angle for stratifying the risk of necrosis in patients with adnexal torsion. MATERIALS AND METHODS: In this multicentre, retrospective study, 72 patients underwent preoperative CT and surgically verified adnexal torsion. Surgeons identified the torsion angle and adnexal necrosis requiring adnexectomy. The twisted angles were compared between conservative surgery group and salpingo-oophorectomy group. Variables included demographic, pathological and CT details. Logistic analysis was used to identify the indicators of twisted angle associated with high-risk necrosis. RESULTS: The necrosis associated with adnexal torsion treated with adnexectomy was performed more often in patients with a torsion angle of ≥720° (odds ratio [OR]=7, 95% confidence interval [CI]: 1.314–37.295, p =0.023). The enlarged twisted pedicle (OR=14.592, 95% CI: 2.048–103.953, p =0.007) and pedicle haemorrhage (OR=5.612, 95% CI: 1.088–28.941, p =0.039) can predict a torsion angle of ≥720°, and area under the receiver operating characteristic (ROC) curve (AUC=0.758±0.058) was generated with the combined variables. CONCLUSION: The risk of adnexal necrosis is high in patients with torsion angle of ≥720°. CT findings of enlarged twisted pedicle and pedicle haemorrhage can be used to predict torsion angle of ≥720° and can imply adnexal necrosis indirectly. Highlights: Necrosis of adnexal torsion is more common in patients with torsion angle of ≥ 720°. CT findings of enlarged twisted pedicle can predict torsion angle of ≥ 720°. CT findings of pedicle haemorrhage can predict torsion angle of ≥ 720°. CT findings are useful for the prediction of necrosis of adnexal torsion.