EURORAD ESR

Case 10066

Diagnostic management of a premenarcheal virgin patient affected by iodine contrast allergy and adnexal torsion

Author(s)
Fiaschetti Valeria, Fabiano Sebastiano, Morosetti Daniele, Ricci Aurora, Antonicoli Marco, Simonetti Giovanni

University hospital "Policlinico Tor Vergata";
Rome; Italy
 
Patient
female, 15 year(s)
 
 
  • Figure 1
    Ultrasound

    Ultrasound imaging shows uterus with the contiguous enlarged left ovary and giant cyst which cause constriction of the left bladder wall.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 2
    CT
     

    Axial image confirms the enlarged left ovary, associated to the giant cyst. There are no direct signs of abundant inflammatory fluid in the pouch of Douglas.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;

    Coronal CT examination shows the left ovary characterised by the maximum diameter of 65 mm.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;

    Coronal image shows giant cyst on the compressed bladder wall.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 3
    MR
     

    Coronal T1-weighted image shows the association between the giant cyst and the enlarged left ovary.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;

    Coronal T2-weighted image depicts the cyst, that measured about 94 mm in maximum diameter, and compression of the urinary bladder.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;

    Axial SPIR image shows a hyperintense left ovary, probably related to the intra-parenchymal oedema, with peripherally located small follicles. Inflammatory fluid was present around the left adnexa and in the pouch of...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;

    Sagittal post-contrast T1-weighted image reports a low contrast enhancement inside the parenchyma, due to the feeding artery torsion.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
Ultrasound imaging shows uterus with the contiguous enlarged left ovary and giant cyst which cause constriction of the left bladder wall.
 
Axial image confirms the enlarged left ovary, associated to the giant cyst. There are no direct signs of abundant inflammatory fluid in the pouch of Douglas.
 
Coronal CT examination shows the left ovary characterised by the maximum diameter of 65 mm.
 
Coronal image shows giant cyst on the compressed bladder wall.
 
Coronal T1-weighted image shows the association between the giant cyst and the enlarged left ovary.
 
Coronal T2-weighted image depicts the cyst, that measured about 94 mm in maximum diameter, and compression of the urinary bladder.
 
Axial SPIR image shows a hyperintense left ovary, probably related to the intra-parenchymal oedema, with peripherally located small follicles. Inflammatory fluid was present around the left adnexa and in the pouch of Douglas.
 
Sagittal post-contrast T1-weighted image reports a low contrast enhancement inside the parenchyma, due to the feeding artery torsion.
 
 
 
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