Computed tomography and magnetic resonance imaging features of adnexal and leiomyoma torsion: correlation with laparoscopic findings

Abstract

Adnexal torsion and pedunculated subserosal leiomyoma torsion are significant gynecological emergencies requiring prompt recognition and surgical intervention. Although ultrasound remains the primary imaging modality, cross-sectional imaging with computed tomography and magnetic resonance imaging plays a crucial role in diagnosis, particularly in complex cases. This review provides a comprehensive analysis of the imaging features of various types of torsion, with direct correlation with laparoscopic findings. We describe key imaging features across different modalities, focusing on specific manifestations of ovarian torsion variants, including massive ovarian edema, mature cystic teratoma, fibroma, and mucinous cystadenoma. Special attention was given to isolated fallopian tube torsion and its subtypes and the unique features of leiomyoma torsion. Understanding these imaging features and their correlation with laparoscopic findings is crucial for accurate diagnosis and appropriate surgical planning. This review emphasizes the importance of recognizing specific imaging patterns that can help guide clinical decision-making and improve patient outcomes through timely intervention.