Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, 49100 Petach Tikva, Israel.
J Ultrasound Med. 2011 Sep;30(9):1205-10. doi: 10.7863/jum.2011.30.9.1205.
The purpose of this study was to determine the accuracy of sonographic diagnosis of ovarian torsion and the predictive value of typical sonographic signs.
The study included 63 women attending an ultrasound unit of a tertiary obstetrics and gynecology department in 2002 through 2008 who had suspected ovarian torsion on sonography and subsequently underwent laparoscopy.
Sonography had diagnostic accuracy of 74.6% for ovarian torsion. Abnormal ovarian blood flow and the presence of free fluid were the most diagnostically accurate isolated sonographic signs (positive predictive values, 80.0% and 89.2%, respectively; negative predictive values, 46.2% and 46.2%). Using combinations of sonographic signs yielded higher specificity and positive predictive values and lower sensitivity and negative predictive values for ovarian torsion. The diagnostic accuracy was largely affected by the ultrasound operator (mean ± SD, 78.8% ± 16.0%; range, 60.0%-100%).
In the setting of a specialized ultrasound unit, sonographic diagnosis of ovarian torsion had high (74.6%) accuracy compared with previous reports. The absence of typical sonographic signs does not rule out ovarian torsion, especially when the clinical presentation is suggestive. Basing assessments on multiple sonographic signs, including Doppler evaluation, increases the diagnostic specificity.
本研究旨在确定超声诊断卵巢扭转的准确性以及典型超声征象的预测价值。
该研究纳入了 2002 年至 2008 年间在一家三级妇产科超声科就诊的 63 名疑似卵巢扭转的女性，这些患者随后接受了腹腔镜检查。
超声对卵巢扭转的诊断准确率为 74.6%。异常卵巢血流和游离液的存在是最具诊断准确性的孤立超声征象（阳性预测值分别为 80.0%和 89.2%；阴性预测值分别为 46.2%和 46.2%）。使用超声征象组合可提高卵巢扭转的特异性和阳性预测值，同时降低敏感性和阴性预测值。超声诊断的准确性在很大程度上受到超声操作者的影响（平均值±标准差，78.8%±16.0%；范围，60.0%-100%）。
在专门的超声科中，与以往报道相比，超声诊断卵巢扭转的准确性较高（74.6%）。缺乏典型的超声征象并不能排除卵巢扭转，尤其是当临床表现提示存在该疾病时。基于多个超声征象（包括多普勒评估）进行评估可提高诊断的特异性。
