Purpose or Case Report:
Adnexal torsion is a common emergency room query in young girls and teenagers presenting with pelvic pain. It is a consequence of an underlying adnexal lesion or to anatomical laxity of the suspensory/anchoring ligaments. Clinical symptoms at presentation can be confusing and nonspecific, yet prompt diagnosis and surgical intervention are essential to save the adnexa. Radiology plays a crucial role in the diagnosis of adnexal torsion. Our exhibit will review and promote the rapid MRI as the first line, one-stop imaging in the diagnosis of adnexal torsion and other causes of pelvic pain. Some cases will be presented with initial ultrasound images and demonstrate how MRI increased the confidence in the diagnosis. All presented cases have pathology correlation and or operative reports and follow-up imaging. We will show various cases of ovarian and tubal torsions and their mimickers. In particular, we include torsions due to anatomical laxity of the suspensory ligaments, resulting from tubo-ovarian cysts and solid adnexal masses as well as cases of isolated tubal torsions.

Table of Contents/Outline:

Review of the embryology and anatomy of adnexa including suspensory/ anchoring ligaments.
Review pathophysiology and progression of ovarian torsion
Review rapid motion insensitive high-resolution MRI protocol for adnexal torsion
Review hallmark imaging findings of adnexal torsion with MRI (with accompanying ultrasound comparison in some cases)
Review MRI findings of adnexal viability and demise
Review multiple MRI examples of adnexal torsion and its mimickers
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