Obstetrics, Gynecology, and Reproductive Sciences Department, Minimally Invasive Gynecology Division, Miller School of Medicine, University of Miami, Miami, FL, USA.
Faculty of Medicine, Damascus University, Damascus, Syria.
Minim Invasive Ther Allied Technol. 2022 Apr;31(4):620-627. doi: 10.1080/13645706.2021.1878376. Epub 2021 Feb 8.
Color Doppler ultrasonography (CDU) is widely used to diagnose adnexal torsion (AT). However, its validity remains questionable due to its low sensitivity. Our study aimed to evaluate the accuracy of CDU for the preoperative diagnosis of AT.
The electronic medical records of patients who were taken to the operating room with the diagnosis of suspected AT were reviewed. Patients having surgically/pathologically-proven AT were compared with patients who were found to have a different pathology at the time of surgery. CDU validity was assessed using a 2 × 2 table and compared with a diagnostic model that consists of the Doppler findings, patient's age, and previous surgical history.
AT was diagnosed correctly in 74.6% of cases. Absent Doppler flow was seen in only 18.6% of cases. Although its specificity and positive predictive value were high, CDU had very low sensitivity and negative predictive value. The combined diagnostic model exceeded CDU alone in terms of diagnostic accuracy.
The use of CDU alone is not a reliable modality to exclude AT. Absent Doppler flow is a sign of ovarian necrosis. Clinical correlation between CDU findings and the patient's symptoms makes the diagnosis of AT more timely and accurate.
彩色多普勒超声（CDU）广泛用于诊断附件扭转（AT）。然而，由于其灵敏度低，其有效性仍存在疑问。我们的研究旨在评估 CDU 术前诊断 AT 的准确性。
回顾因疑似 AT 而被送往手术室的患者的电子病历。将手术/病理证实的 AT 患者与手术时发现不同病理的患者进行比较。使用 2×2 表评估 CDU 的有效性，并与由多普勒发现、患者年龄和既往手术史组成的诊断模型进行比较。
AT 在 74.6%的病例中得到正确诊断。仅在 18.6%的病例中观察到无多普勒血流。尽管 CDU 的特异性和阳性预测值较高，但灵敏度和阴性预测值较低。与 CDU 单独相比，联合诊断模型在诊断准确性方面更优。
单独使用 CDU 不能可靠地排除 AT。无多普勒血流是卵巢坏死的标志。 CDU 检查结果与患者症状之间的临床相关性使 AT 的诊断更加及时和准确。
