Özdemir Oğuzhan, Metin Yavuz, Metin Nurgül Orhan, Küpeli Ali
Faculty of Medicine, Department of Radiology, RTEÜ, 53100, Rize, Turkey.
Department of Radiology, Muş State Hospital, Muş, Turkey.
BMC Med Imaging. 2017 Nov 22;17(1):56. doi: 10.1186/s12880-017-0232-6.
To assess the role of DWI in differentiation haemorrhagic ovary infarction from non-haemorrhagic one.
For this prospectively designed study, of 117 female patients who presented with acute lower quadrant pain and underwent MRI for suspicion of ovary torsion, results of only 29 patients (mean age, 24.7; SD, ±5.7; age range, 18-37), with surgical and pathological confirmation of adnexal torsion, were included to the study. All patients underwent DWI after conventional MRI. Quantitative and qualitative analysis of both the torsed and contralateral normal ovary were performed. Results of conventional MRI and DWI were noted.
At operation 15 patients were found to have haemorrhagic infarction while 14 had non-haemorrhagic infarction. Of the 29 patients, 17 torsed ovaries could be salvaged in a viable state. We found statistically significant correlation of the ADC values, between haemorrhagic and non-haemorrhagic ovary infarction. The ADC values were significantly lower in patients with haemorrhagic infarction than non-haemorrhagic ones (p < 0.001). Using an ADC threshold of 1.27, the sensitivity of DWI for haemorrhagic infarction was 0.93 and specificity 0.85.
DWI may be used with a significant success for the preoperative diagnosis of haemorrhagic infarction. This may be alerting for pre-emptive surgery in avoiding serious complications and preventing irreversible structural damage of the ovary.
评估弥散加权成像（DWI）在鉴别出血性卵巢梗死与非出血性卵巢梗死中的作用。
在这项前瞻性设计的研究中，对117例因急性下腹部疼痛就诊且因怀疑卵巢扭转而接受磁共振成像（MRI）检查的女性患者进行研究，最终仅纳入29例（平均年龄24.7岁；标准差±5.7；年龄范围18 - 37岁）经手术及病理证实为附件扭转的患者。所有患者在常规MRI检查后均接受DWI检查。对扭转侧及对侧正常卵巢进行定量和定性分析。记录常规MRI和DWI的结果。
手术中发现15例患者为出血性梗死，14例为非出血性梗死。在这29例患者中，17个扭转的卵巢得以成功挽救。我们发现出血性和非出血性卵巢梗死的表观扩散系数（ADC）值具有统计学意义的相关性。出血性梗死患者的ADC值显著低于非出血性梗死患者（p < 0.001）。以1.27作为ADC阈值，DWI对出血性梗死的敏感性为0.93，特异性为0.85。
DWI在出血性梗死的术前诊断中可能会取得显著成功。这可能有助于提醒进行预防性手术，以避免严重并发症并防止卵巢发生不可逆的结构损伤。
