Chang et al listed changes that can be seen on gray-scale ultrasonography in a woman with ovarian torsion. The authors are from the University of Rochester.


Features of ovarian torsion on gray-scale ultrasonography:

(1) enlarged ovary > 4 cm, typically unilateral and extending to the midline

(2) “string of pearls” sign (multiple uniform follicular cysts aligned in the periphery)

(3) often a mass present in the ovary (teratoma, etc)

(4) free fluid present in the cul-de-sac

(5) vascular pedicle of the ovary twisted


Most of these findings are nonspecific and can be seen in other conditions. Their presence in a woman with acute abdominal pain suggests ovarian torsion.


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