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  • Title: Fluid-debris level in follicular cysts: a pathognomonic sign of ovarian torsion.
    Author: Kiechl-Kohlendorfer U, Maurer K, Unsinn KM, Gassner I.
    Journal: Pediatr Radiol; 2006 May; 36(5):421-5. PubMed ID: 16525772.
    Abstract:
    BACKGROUND: Early diagnosis of ovarian torsion is mandatory to avoid common complications. Sonography is the imaging modality of choice, but diagnosis is still a challenge. OBJECTIVE: To report an additional sonographic feature of ovarian torsion in order to improve diagnostic accuracy. MATERIALS AND METHODS: Grey-scale and colour Doppler pelvic sonography was performed in 12 patients with acute onset of intermittent lower abdominal pain and in 1 asymptomatic patient with a palpable mass in the labium majus. Patient ages ranged from 4 months to 17 years. RESULTS: In all patients an enlarged ovary with peripheral cysts was demonstrated. High-resolution sonography detected fluid-debris levels within these cystic structures in 11 of the 13 patients (sensitivity 85%) and provided an additional diagnostic sign. Six patients had cystic teratoma. CONCLUSIONS: We confirm the fluid-debris level as a pathognomonic sonographic sign of ovarian torsion with or without associated teratoma.
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