Kiran Shakeel, Syeda Khadija-Tul-Sughra Murrium, Maria Yaseen, Alia Iqbal, Sara Yaseen, Saad Qayyum

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Comparison of Ultrasonography with other Imaging Modalities for Detection of Adnexal Torosion: A Systematic Review

Kiran Shakeel, Syeda Khadija-Tul-Sughra Murrium, Maria Yaseen, Alia Iqbal, Sara Yaseen, Saad Qayyum



Background: Adnexal Torsion (AT), serious emergency of gynecology, frequently shows among nonspecific signs prominent to late analysis.

Aim:  To compare the test accuracy of Ultrasound, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) for diagnosis of adnexal torsion.

Methodology:  We observed google scholar as well as Radiographics key till Dec 2019. Assortment standards studies report upon Imaging Modality accuracy (index test) within paediatric and adult females alleged of adnexal torsion matched by clinical analysis or usual clinical or radiological follow up duration till symptoms firmness (reference standard).

Results: We mark off 3836 references, comprised 18 Studies (1654 females, 665-cases), as well as comprised 15 into meta analyses, ultrasound pooled-sensitivity (n =12, 1187 females) was 0.79 (95% CI= 0.63 to 0.92) as well as specificity was 0.76 (95% CI= 0.54 to 0.93), by means of positive as well as negative probability fractions 4.35 (95% CI= 2.03 to 9.32) and 0.29 (95% CI= 0.13 to 0.66), correspondingly. By Doppler Ultrasound (n=7, 845 females) produced alike and specificity (0.88, 95% CI= 0.72 to 1.00) and sensitivity (0.80, 95% CI= 0.67 to 0.93). For magnetic resonance imaging (n=3, 99 females), pooled-sensitivity was 0.81 (95% CI=0.63 to 0.91) as well as specificity was 0.91 (95% CI= 0.80 to 0.96). Meta-analysis for Computed Tomography was impossible by 2 case control-studies as well as one cohort-study (n=3, 232 females). Its range of sensitivity was 0.74 to 0.95 as well as specificity 0.80 to 0.90. 

Conclusions:  As a first line analytic examination for alleged AT, ultrasound has good performance. Increment in quantity of AT cases needs precise, rapid, as well as correct analytic extent. It has been utmost popular method as allied with further Imaging Modalities. MRI might compromise better specificity for investigating intricate morphology of ovary, nonetheless further proof is wanted. Beside with medical doubt as well as approximations. This study will offer sufficient appreciated evidence to understand sonographic markers impact during OT analysis precisely.

Keywords: Adnexa, Computed Tomography, Doppler, Magnetic Resonance Imaging, Meta-analysis, Ovary, Test Accuracy, 

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