Torsion of a normal adnexa in a premenarcheal girl: MRI findings

Abstract

Torsion of the adnexa can be the cause of abdominal pain. An immediate diagnosis is very important because early surgical intervention is the only way to save the ovary from necrosis. Torsion of a normal adnexa is rare, but occurs more frequently than is generally appreciated. If US findings are equivocal, MRI can provide additional information. In our case the MRI findings leading to the diagnosis of ovarian torsion were: (a) A medial ovarian mass existed with dislocation of the uterus to the affected side with hyperintense, cystic lesions on T2-weighted images at the periphery of the ovary. (b) Beaked protrusion of the mass continuing in a band-like structure connecting it with the uterus obviously represented the Fallopian tube. (c) Low and inhomogeneous signal intensity of the stroma on T1- and T2-weighted images and lack of gadolinium uptake were indicative of infarction.