Akademik Veri Yönetim Sistemi
Clinical and Experimental Obstetrics and Gynecology, cilt.52, sa.8, 2025 (SCI-Expanded)
Background: Adnexal torsion is a gynecological emergency that can lead to loss of ovarian function if not diagnosed promptly. This study aimed to determine which computed tomography (CT) findings, or combinations of findings, can accurately diagnose adnexal torsion in women presenting with abdominal pain and adnexal masses. Methods: In this retrospective single-center cohort study conducted between January 2018 and December 2023, a total of 66 patients were evaluated. Group 1 (n = 35; 53%) included women who underwent preoperative CT for abdominal pain and were subsequently diagnosed with adnexal torsion. Group 2 (n = 31; 47%) served as the control group and comprised patients who underwent preoperative CT for untwisted adnexal masses. Statistical analysis was performed using SPSS version 26.0. Normality was assessed with the Kolmogorov-Smirnov test. Non-normally distributed variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed using the chi-square test or Fisher’s exact test. Interobserver agreement for CT findings was evaluated, and logistic regression analyses were conducted. A p-value < 0.05 was considered statistically significant. Results: Interobserver agreement was almost perfect for the identification of unusual adnexal and uterus location, the presence of an interutero-ovarian mass, the whirlpool sign, peritoneal effusion, and tubal thickening. The unusual location of the adnexa and the presence of the whirlpool sign were significantly more frequent in the adnexal torsion group (Group 1) and remained statistically significant in the logistic regression analysis. Conclusion: Accurate interpretation of CT scans performed in emergency settings, particularly in experienced centers, may help in reliably diagnosing or excluding adnexal torsion, potentially reducing unnecessary surgical interventions.