EM Quick Hits Video on Ovarian Torsion Imaging Myths with Brit Long
- Myth #1: Normal arterial flow on Doppler ultrasound rules out ovarian torsion.
- Normal Doppler US cannot rule out ovarian torsion
- Many cases of surgically confirmed ovarian torsion have completely normal venous and arterial blood flow
- The most common finding on US is an enlarged ovary (> 4 cm).
- Consider using a combination of US findings, such as abnormal vascular flow, free fluid on US, an ovary pushed towards the midline, or increased ovarian size.
Myth #2: CT of the abdomen/pelvis is not helpful in evaluation of suspected ovarian torsion.
- CT with IV contrast can suggest torsion.
- The most common finding on CT is an enlarged ovary. If this is found on CT and no other pathology is present, move to US.
- Other findings include an underlying ovarian lesion, lack of enhancement, inflammatory fat stranding around the ovary, free pelvic fluid surround the ovary, and twisting of the vascular pedicle.
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