Ovarian Torsion: Likelihood Ratios

Introduction: Torsion of the ovary blocks venous outflow (and less commonly arterial inflow), leading to swelling of the ovary and subsequent occlusion of arterial blood flow. In adults, 94% of ovarian torsions were from masses (half cysts and half neoplasms). However, >50% of torsions in children < 15 years of age occur in normal ovaries.

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The likelihood ratios of findings for Ovarian Torsion are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding	+LR	-LR	Comments, Study
Doppler Ultrasound	46.5	0.1	The findings may be decreased or absent venous and/or arterial flow - here the criterion is simply any abnormality. Study: J Ultrasound Med 2001 Oct;20(10):1083-9. PMID 11587015 Eur J Obstet Gynecol Reprod Biol 2002 Aug 5;104(1):64-6. PMID 12128265

Poorly Diagnostic Findings

Finding	+LR	-LR	Comments, Study
Ovarian Mass by Ultrasound	Sensitivity = 100%		Only 15 patients. No specificity. Study: J Ultrasound Med 2001 Oct;20(10):1083-9. PMID 11587015
Fluid in Cul-de-Sac	Sensitivity = 87%		(By ultrasound) Study: J Ultrasound Med 2001 Oct;20(10):1083-9. PMID 11587015