DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20151633

MRI diagnosis of tubal torsion: the whirlpool sign

Anuj Thakral, Rajeev Malhotra, Nitika Sobti, Ankita Chandna, Manisha Arora

Abstract


Isolated fallopian tube torsion is a rare cause of acute lower abdominal pain with multiple described contributory factors resulting in tubal necrosis and gangrene. While clinical presentation is nonspecific with a wide clinical differential diagnosis, a combination of sonographic or MRI whirlpool sign with a dilated fallopian tube and normal appearing ipsilateral ovary helps make a preoperative diagnosis of tubal torsion. We report a case of a middle aged female who was diagnosed with tubal torsion on preoperative MRI and is the first description of MRI whirlpool sign for diagnosis of tubal torsion from the Indian subcontinent to our knowledge. The whirlpool mass in tubal torsion is much smaller than ovarian torsion and may be less obvious on ultrasound as in present case.

Keywords


Fallopian tube, Magnetic resonance imaging, Ultrasonography, Gangrene

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References


Hansen OH. Isolated torsion of the Fallopian tube. Acta Obstet Gynecol Scand.1970;49(1):3-6.

Binkovitz L, Naprawa J, Binkovitz L. Cross sectional imaging of ovarian and isolated fallopian tube torsion. Accessed online from October 2015.

Bland Sutton J. Remarks on salpingitis and some of its effects. The Lancet. 1890;136(3509):1146-8.

Krissi H, Shalev J, Bar-Hava I, Langer R, Herman A, Kaplan B. Fallopian tube torsion: laparoscopic evaluation and treatment of a rare gynecological entity. J Am Board Fam Med. 2001;14(4):274-7.

Bernardus RE, Van der Slikke JW, Roex AJ, Dijkhuizen GH, Stolk JG. Torsion of the fallopian tube:some considerations on its etiology. Obstet Gynecol .1984;64(5):675–8.

Ghossain MA, Buy JN, Bazotetal M. CT in adnexal torsion with emphasis on tubal findings: correlation with US. J Comput Assist Tomogr. 1994;18(4):619-25.

Wong SW, Suen SH, Lao T, Chung KH. Isolated fallopian tube torsion: a series of six cases. Acta Obstet Gynecol Scand. 2010;89(10):1354-6.

Shukla R. Isolated torsion of the hydrosalpinx: a rare presentation. Br J Radiol . 2004;77(921):784-6.

Sherer DM, Liberto L, Abramowicz JS, Woods JR Jr. Endovaginal sonographic features associated with isolated torsion of the fallopian tube. J Ultrasound Med. 1991;10(2):107–9.

Baumgartel P, Fleischer A, Cullinan J, Bluth R. Color Doppler sonography of tubal torsion. Ultrasound in Obstetrics and Gynecology. 1996;7(5):367-70.

Vijayaraghavan SB, Senthil S. Isolated torsion of the fallopian tube – the sonographic whirlpool sign. J Ultrasound Med. 2009;28(5):657-62.

Hiller N, Appelbaum L, Simanovsky N, Lev-Sagi A, Aharoni D, Sella T. CT features of adnexal torsion. Am J Roentgenol. 2007;189(1):124-9.

Kardakis S, Barranca A, Vitelli A, Amore I, Trento F, Caccia G. Isolated fallopian tube torsion. Case Rep Obstet Gynecol. 2013;2013:479698.

Aydin R, Bildircin D, Polat AV. Isolated torsion of the fallopian tube with hydrosalpinx mimicking a multiloculated ovarian cyst: whirlpool sign on preoperative sonography and MRI. J Clin Ultrasound. 2014;42(1):45-8.

Ghonge NP, Lall C, Aggarwal B, Bhargava P. The MRI whirlpool sign in the diagnosis of ovarian torsion. Radiol Case Rep. 2012;7(3).