Department of Radiology, Azienda Ospedaliera San Camillo Forlanini, C.Ne Gianicolense, 87, 00152, Rome, Italy.
Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy.
J Ultrasound. 2021 Dec;24(4):505-514. doi: 10.1007/s40477-021-00601-y. Epub 2021 Jun 26.
To describe contrast enhanced ultrasound (CEUS) characteristics of ovarian torsion in pediatric females, assessing the potential diagnostic advantages of method as well as its limitations.
A retrospective study design was used. Between January 2018 and December 2020 we analyzed all pediatric females who underwent explorative surgery with a suspected diagnosis of ovarian torsion, and who were previously evaluated by conventional ultrasound (US), color-Doppler ultrasound (CDUS) and CEUS.
We examined twenty pediatric females with a median age of 12 years. US identified 9/20 ovarian complex masses against 13/20 by CEUS. At US abdominal free fluid was shown in 13/20 patients and in 18/20 cases with CEUS. In our case series the evaluation of contrast enhancement at CEUS in the detection of ovarian torsions revealed a sensitivity of 94.1%, a specificity of 100% and an overall accuracy of 95%.
Although there is a known ultrasound semeiotics suggestive of ovarian torsion, it is not always possible to obtain a diagnosis of certainty with conventional US even with CDUS. The study reports that complementation with CEUS showed excellent agreement with surgery obtaining a diagnosis in almost all the pediatric females examined.
描述小儿女性卵巢扭转的超声造影(CEUS)特征,评估该方法的潜在诊断优势及其局限性。
采用回顾性研究设计。我们分析了 2018 年 1 月至 2020 年 12 月期间所有因疑似卵巢扭转而行探查性手术的小儿女性,这些患者术前均接受了常规超声(US)、彩色多普勒超声(CDUS)和 CEUS 检查。
我们检查了 20 名年龄中位数为 12 岁的小儿女性。US 发现 20 例卵巢复杂肿块中的 9 例,CEUS 发现 20 例中的 13 例。US 显示 13/20 例患者存在腹腔游离液体,CEUS 显示 18/20 例存在腹腔游离液体。在我们的病例系列中,CEUS 增强评估在卵巢扭转检测中的敏感性为 94.1%,特异性为 100%,总体准确性为 95%。
尽管存在提示卵巢扭转的超声表现,但即使使用 CDUS,常规 US 也并非总能确诊。本研究报告称,CEUS 补充检查与手术具有极好的一致性,几乎对所有接受检查的小儿女性都能做出明确诊断。