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“Perifollicular rim sign” in an enlarged ovary—an additional non-contrast CT finding in ovarian torsion

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Abstract

Purpose

To look for the presence of “perifollicular rim sign” on non-contrast CT in surgically proven cases of ovarian or adnexal torsion.

Methods

A retrospective analysis of abdominopelvic non-contrast CT examinations in surgically proven cases of ovarian or adnexal torsion was conducted seeking the presence of “perifollicular rim sign” in torsed ovaries. “Perifollicular rim sign” was defined as a complete ring of perifollicular hyperdensity around ovarian follicles with an attenuation value of > 50 HU and thickness > 1–2 mm. A positive sign was equated to the presence of perifollicular hemorrhage. Pre-operative non-contrast CT was available in 7 out of the 39 ovarian or adnexal torsions included in our study.

Results

“Perifollicular rim sign” was present in 5 out of the 7 ovarian torsions on pre-operative non-contrast CT. MRI correlation was available in one patient. Ovarian enlargement (>4 cm) was present in all 7 cases.

Conclusion

In an appropriate clinical setting, presence of “perifollicular rim sign” in an enlarged ovary on non-contrast CT examination can be considered a useful additional sign for ovarian torsion.

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Authors and Affiliations

  1. Department of Radiology and Medical Imaging, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22908, USA

    Prem P. Batchala

  2. Department of Radiology, St. Vincent’s Medical Center, Bridgeport, CT, 06606, USA

    Pankaj Nepal

  3. Department of Radiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, Meghalaya, 793012, India

    Baphiralyne Wankhar

  4. Department of Clinical Imaging, Al Khor Hospital, Hamad Medical Corporation, P O Box 3050, Al Khor, Qatar

    Shanmugavel Chinnakaruppan

  5. Wollongong Diagnostics, 340 Crown Street, Wollongong, NSW, 2500, Australia

    Maneesh Khanna

  6. Department of Radiology, University of Texas Health, San Antonio, TX, 78229, USA

    Vijayanadh Ojili

Authors
  1. Prem P. Batchala
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  2. Pankaj Nepal
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  3. Baphiralyne Wankhar
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  4. Shanmugavel Chinnakaruppan
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  5. Maneesh Khanna
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  6. Vijayanadh Ojili
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All authors made substantial contributions towards conception, analysis and interpretation of data, drafting the manuscript, and critical revision. The authors agree to be accountable for all aspects of the work.

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Correspondence to Prem P. Batchala.

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Batchala, P.P., Nepal, P., Wankhar, B. et al. “Perifollicular rim sign” in an enlarged ovary—an additional non-contrast CT finding in ovarian torsion. Emerg Radiol 28, 621–626 (2021). https://doi.org/10.1007/s10140-021-01904-7

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  • DOI: https://doi.org/10.1007/s10140-021-01904-7

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