Introduction: 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.
Material and methods: The electronic medical records of patients who were taken to the oper- ating room with the diagnosis of suspected AT were reviewed. Patients having surgically/patho- logically-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 diag- nostic model that consists of the Doppler findings, patient’s age, and previous surgical history. Results: 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.
Conclusions: 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.
Abbreviations: AT: adnexal torsion; ACOG: American College of Obstetricians and Gynecologists; CDU: color doppler ultrasonography; MRI: magnetic resonance imaging; CT: com- puted tomography