CT in adnexal torsion with emphasis on tubal findings : correlation with US

Our goal was to determine the CT and US aspects of the fallopian tube in adnexal torsion. The CT scans and US studies of 10 patients with surgically proven unilateral torsion of the adnexa were reviewed. On CT the fallopian tube on the involved side was identified in eight cases as an almost tubular or comma-shaped structure extending from the uterine cornua and covering partially the adnexal mass. This tube was significantly thickened and measured 20–40 mm. Hemorrhage (density ≥50 HU on precontrast CT scans) was present in the tube in six patients. A heterogeneous contrast agent uptake was detected in the tube in five patients. An adnexal mass was visualized on the involved side in all patients, with hemorrhage in the mass in four patients. Peritoneal fluid and/or ileus were present in six patients. On US an echogenic structure that corresponded to the enlarged tube visualized on CT was detected in three cases and an adnexal mass in all cases. Thickening of the fallopian tube with hemorrhage could be detected by CT and is suggestive of torsion especially if associated with an adnexal mass.