Diagnosis of neonatal ovarian torsion: Emphasis on prenatal and postnatal sonographic findings

• Published in: Journal of clinical ultrasound 2016-06, Vol.44 (5), p.290-297
• Main Authors: Kim, Hyun Su, Yoo, So-Young, Cha, Min Jae, Kim, Ji Hye, Jeon, Tae Yeon, Kim, Wee Kyoung
• Format: Article
• Language: English
• Subjects: Female; Humans; Infant, Newborn; neonate; obstetrics; Ovarian Cysts - complications; Ovarian Cysts - diagnostic imaging; Ovarian Cysts - surgery; Ovarian Diseases - complications; Ovarian Diseases - diagnostic imaging; Ovarian Diseases - surgery; ovarian torsion; Ovary - diagnostic imaging; Ovary - surgery; pediatrics; Pregnancy; Pregnancy Trimester, Third; Retrospective Studies; Torsion Abnormality - complications; Torsion Abnormality - diagnostic imaging; Torsion Abnormality - surgery; Ultrasonic imaging; ultrasonography; Ultrasonography - methods; Ultrasonography, Prenatal - methods
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.22327

ABSTRACT Purpose Our aim was to retrospectively review the imaging findings of patients with neonatal ovarian torsion, emphasizing prenatal and postnatal sonographic findings. Methods Eleven patients who had had neonatal ovarian torsion diagnosed surgically (n = 9) or clinicoradiologically (n = 2) were enrolled. Prenatal and postnatal sonographic features, including sequential postnatal change, were reviewed. Clinical and pathologic features were also investigated. Results All patients except one had a fetal ovarian cyst (mean, 5.3 cm) detected on third‐trimester sonography, either simple (n = 6) or complex (n = 4). In all 11 patients, initial postnatal sonography had revealed a complex cyst (mean, 4.7 cm) with intracystic clot or debris, the double‐wall sign, a fluid–fluid level, and multiple septation. None of the patients had had symptoms or signs related to the ovarian torsion. Follow‐up sonography in seven patients had revealed increased echogenicity of the cyst wall with frequent calcification and a decrease in size of the cyst. In two patients, the interval of the change in cyst position was noted, and autoamputation of the torsed ovary had been surgically confirmed. Serous cystadenoma had been identified in one patient. Conclusions Neonatal ovarian torsion most commonly manifests as an asymptomatic complex cyst on sonography due to torsion of a fetal ovarian cyst. Serial monitoring of a fetal ovarian cyst for its resolution or changes in its appearance is mandatory for making an early diagnosis of torsion. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:290–297, 2016