Sonographic signs of pediatric ovarian torsion: Multicenter study with surgical correlation

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-18 DOI:10.1016/j.ejrad.2025.112258

Yassir Edrees Almalki , Mohammad Abd Alkhalik Basha , Mohamad Gamal Nada , Mona Mohammed Refaat , Majed Saeed Alshahrani , Sharifa Khalid Alduraibi , Ziyad A. Almushayti , Ahmed M. Abdelkhalik Basha , El-Shaimaa Mohamed Mohamed

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引用次数: 0

Abstract

Objective

Pediatric ovarian torsion is a rare but serious condition that requires prompt diagnosis to prevent ovarian damage. This study evaluated the predictive value and reliability of specific sonographic signs in diagnosing pediatric primary ovarian torsion and correlated these findings with surgical outcomes.

Materials and methods

This retrospective multicenter study analyzed ultrasound and surgical records from 103 girls aged 7–14 diagnosed with suspected ovarian torsion across three institutions from November 2021 to June 2024. Three senior radiologists independently reviewed ultrasound findings, and surgical records served as the reference standard. Diagnostic performance was calculated for each ultrasound sign, both individually and in combination. Univariate and multivariate logistic regression analyses were performed to assess the predictive value of these signs. The inter-reviewer agreement (IRA) among three radiologists was also evaluated using Fleiss kappa statistics.

Results

Ovarian torsion was confirmed in 87 out of 103 cases (84.5 %). The most predictive sonographic signs were ovarian enlargement (OR = 10.09, 95 %CI: 2.01–50.57, p < 0.005), abnormal ovarian position (OR = 8.65, 95 %CI: 1.89–39.52, p < 0.005), and abnormal blood flow (OR = 5.61, 95 %CI: 1.12–28.17, p = 0.036). Ovarian enlargement had the highest sensitivity (92 %), while follicular ring sign showed perfect specificity (100 %). The combination of abnormal ovarian position and enlargement yielded a high positive predictive value (98.6 %). The IRA was excellent for ovarian enlargement (κ = 0.90) and abnormal position (κ = 0.85).

Conclusion

Ovarian enlargement, abnormal ovarian position, and abnormal blood flow are reliable predictors of pediatric ovarian torsion on ultrasound. Combining these signs improves diagnostic accuracy and can guide timely surgical intervention.

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小儿卵巢扭转的超声征象：与手术相关的多中心研究

目的小儿卵巢扭转是一种罕见但严重的疾病，需要及时诊断以预防卵巢损伤。本研究评估了特定超声征象在诊断小儿原发性卵巢扭转中的预测价值和可靠性，并将这些征象与手术结果相关联。材料和方法本回顾性多中心研究分析了三家机构从2021年11月至2024年6月诊断为疑似卵巢扭转的103名7-14岁女孩的超声和手术记录。三位资深放射科医生独立审查超声检查结果，并将手术记录作为参考标准。计算每个超声征象的诊断性能，无论是单独的还是联合的。单因素和多因素逻辑回归分析评估这些迹象的预测价值。三位放射科医师的审稿人间协议（IRA）也使用Fleiss kappa统计进行评估。结果103例患者中有87例确诊为卵巢扭转，占84.5%。最具预测性的超声征象是卵巢增大(OR = 10.09, 95% CI: 2.01-50.57, p <；0.005)，卵巢位置异常(OR = 8.65, 95% CI: 1.89 ~ 39.52, p <；0.005)，血流量异常（OR = 5.61, 95% CI: 1.12 ~ 28.17, p = 0.036）。卵巢肿大的敏感性最高（92%），而卵泡环征的特异性为100%。卵巢位置异常和卵巢肿大合并有较高的阳性预测值（98.6%）。IRA表现为卵巢肿大（κ = 0.90）和卵巢位置异常（κ = 0.85）。结论卵巢肿大、卵巢位置异常、血流异常是儿童卵巢扭转的可靠超声预测指标。结合这些征象可提高诊断的准确性，并可指导及时的手术干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.