Trends in Usage of CT in the Early Detection and Diagnosis of Adnexal Torsion
Ovarian torsion (OT) is frequently considered in the differential diagnosis of women presenting to the ED with pelvic pain, but is a relatively uncommon occurrence. While ultrasound is considered the test of choice for OT, CT may be used as an initial imaging study with undifferentiated pelvic pain. The aim of this study was to determine the frequency of CT used in the diagnostic evaluation of women with proven OT. We hypothesized that all CTs of the pelvis in women with proven OT would be abnormal. This was a retrospective chart review from 500 bed urban teaching hospital. Patients were included who were admitted from 1985-2005and were discharged with ICD-9 code of ovarian or adnexal torsion. Those patients with no surgical evidence of OT after chart review were excluded from the study.
Data gathered were stratified into 4 five-year periods for analysis of imaging trends. 178 cases of surgically proven torsion over 20-year period were reviewed. The average age of the subjects was calculated as 32.2 years with a range from two weeks of age to 84 years. (24.7% of patients under age 18). 136 patients received ultrasounds and 58 patients received CT scans. The percent of patients who received CTs from 1985 until 2005 increased from 12.5% to 34.2%. The percent of patients who received ultrasounds from 1985 to 2005 increased from 37.5% to 58.9%.
From this study we concluded that CT scanning has increased in frequency as a diagnostic tool in the workup of ovarian torsion over the course of the past twenty years. In this study of 178 patients and 58 CT scans there were no normal pelvic CT scans in patients with surgically proven adnexal torsion. This suggests a possible role for CT in excluding the diagnosis of adnexal torsion
School Location:USA - Connecticut
Source Type:Master's Thesis
Keywords:tomography x ray computed pelvic pain ovarian torsion adnexal ct
Date of Publication:11/03/2006