Linam Leann E, Darolia Renuka, Naffaa Lena N, Breech Lesley L, O'hara Sara M, Hillard Paula J, Huppert Jill S
Cincinnati Children's Hospital Medical Center, Department of Radiology, University of Cincinnati School of Medicine, Cincinnati, OH 45229, USA.
Pediatr Radiol. 2007 Oct;37(10):1013-9. doi: 10.1007/s00247-007-0599-6. Epub 2007 Sep 1.
Adnexal torsion is rare, and symptoms are nonspecific. Clinicians often rely on US examinations to evaluate girls with abdominal or pelvic pain.
To determine which sonographic findings can predict adnexal torsion by comparing pediatric and adolescent patients with surgically confirmed torsion (cases) to those without torsion (controls).
Cases and controls were identified retrospectively by searching 7 years of medical record and radiology databases. An adnexal ratio was calculated as the volume of the affected adnexa divided by the volume of the unaffected adnexa.
We identified 61 menarchal subjects: 33 cases and 28 controls. Adnexal volume was larger in cases than in controls (185 vs. 37.8 ml, P < 0.001). A volume of >75 ml was more common in cases than in controls (64 vs. 15%, P < 0.001). No cases had an adnexal volume of <20 ml (P < 0.001). The adnexal ratio was larger in cases than in controls (16.1 vs. 6.7, P < 0.001). An adnexal ratio of >15 was seen in 40% of cases and in no controls (P = 0.08). Doppler US results were not predictive of torsion.
An adnexal volume of <20 ml is strong evidence against adnexal torsion in menarchal females. In this age group, the diagnosis of torsion cannot be established by US examination alone.
附件扭转很少见，且症状不具特异性。临床医生常依靠超声检查来评估有腹痛或盆腔痛的女孩。
通过比较手术确诊为扭转的儿科和青少年患者（病例组）与未发生扭转的患者（对照组），确定哪些超声检查结果可预测附件扭转。
通过检索7年的病历和放射学数据库，回顾性确定病例组和对照组。附件比率计算为患侧附件体积除以未患侧附件体积。
我们确定了61例初潮女性：33例病例和28例对照。病例组的附件体积大于对照组（185 vs. 37.8 ml，P < 0.001）。附件体积>75 ml在病例组中比对照组更常见（64% vs. 15%，P < 0.001）。没有病例的附件体积<20 ml（P < 0.001）。病例组的附件比率大于对照组（16.1 vs. 6.7，P < 0.001）。40%的病例附件比率>15，而对照组无一例如此（P = 0.08）。多普勒超声结果不能预测扭转。
附件体积<20 ml是初潮女性不存在附件扭转的有力证据。在这个年龄组，仅通过超声检查不能确诊扭转。
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