Yoshimitsu Ohgiya MD, Presenter: Nothing to Disclose

Masaaki Kawahara, Abstract Co-Author: Nothing to Disclose

Noritaka Seino, Abstract Co-Author: Nothing to Disclose

Yui Onoda MD, Abstract Co-Author: Nothing to Disclose

Masanori Hirose MD, Abstract Co-Author: Nothing to Disclose

Takehiko Gokan MD, Abstract Co-Author: Nothing to Disclose

To evaluate usefulness of computed tomographic (CT) features for identifying acute torsions of uterine leiomyomas.

We retrospectively analyzed contrast enhanced CT examinations of 7 uterine leiomyomas with acute torsion and 44 without torsion, which has been surgicopathologically confirmed. Two experienced radiologists who were blinded to the surgicopathologic findings evaluated these 2 groups of CT features. The analyzed CT features consisted of poor contrast enhancement inside the leiomyoma, thin rim enhancement around the leiomyoma, calcification within the leiomyoma, beak sign between the uterus and the leiomyoma, wedged poor contrast enhancement area in the uterus adjacent to the leiomyoma, and ascites. We acquired statistical proportions for the frequencies of these CT features in the uterine leiomyomas with torsion versus those without torsion, using the Pearson [chi]2 and Fisher exact tests at 5% levels of significance.

The frequencies of CT features in uterine leiomyomas with torsion and those without torsion were as follows: 86% and 5% with poor contrast enhancement inside the leiomyoma (p = 0.001); 71% and 9% with thin rim enhancement around the leiomyoma (p = 0.001); 29% and 18% with calcification within the leiomyoma (p > 0.05); 57% and 86% with beak sign between the uterus and the leiomyoma (p > 0.05); 57% and 0% with wedged poor contrast enhancement area in the uterus adjacent to the leiomyoma (p = 0.001); 100% and 20% with ascites (p = 0.01). The sensitivity, specificity, and accuracy for diagnosing acute torsion of uterine leiomyoma were as follows: 86%, 96%, and 94%, respectively, with poor contrast enhancement inside the leiomyoma; 71%, 91%, and 88%, respectively, with thin rim enhancement around the leiomyoma; 29%, 82%, and 75%, respectively, with calcification within the leiomyoma; 57%, 14%, and 20%, respectively, with beak sign between the uterus and the leiomyoma; 57%, 100%, and 94%, respectively, with wedged poor contrast enhancement area in the uterus adjacent to the leiomyoma; 100%, 55%, and 61%, respectively, with ascites.

The CT features of poor contrast enhancement, thin rim enhancement, wedged poor contrast enhancement area are valuable for identifying acute torsion of uterine leiomyoma.

These valuable CT features in confirming acute torsion of a uterine leiomyoma would help guide therapeutic decision.

Ohgiya, Y, Kawahara, M, Seino, N, Onoda, Y, Hirose, M, Gokan, T, CT Features for Diagnosing Acute Torsion of Uterine Leiomyoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14008315.html