ULTRASOUND Messages for June, 2005: Re: Uterine vs ovarian

Re: Uterine vs ovarian

From: James Smeltzer

James.Smeltzer@wellstar.org

Tue Jun 14 10:56:27 2005

Just had a case of massive (10 cm) edema of a normal ovary with a partial torsion. Appearance was so bizarre and massive, and with a very LOW RI I thought it was a solid tumor. With a partial torsion, downstream from obstruction, you get (in carotids AND leg arteries AND ovaries) less pulsatile flow because you are observing low resistance runoff below the dam, and the tissue perfused is vasodilated because of the proximal obstruction. THis can be confused with a cancer flow signature - as I was confused. She had the ovary out.

I believe that the partial torsion was primary. With total obstruction and infarction you get no flow. Trace the infundibulopelvic artery & vein with the color or power (if color not sensitive enough) on to show the vessels and the twisting of the partial torsion - at least this is what I plan to have sonographers do NEXT time they find massive ovarian size + low RI of the ovary. ;^}.

Isn't ultrasound great - doing it 20 years and still get surprised....

Jim S

-- James S. Smeltzer, MD, FACOG, SMFM Consultant, Maternal Fetal Medicine Wellstar Physicians' Group Northwest Women's Care 787 Campbell Hill St Marietta GA 30060 James.Smeltzer@wellstar.org VM 678-290-3035 Off 770-528-0260 Page 404-318-3451

>>> suzyhny@yahoo.com 6/13/2005 8:09:23 PM >>>

Hi Everybody

The only experience I have had with uterine and ovarian arteries is when I do ovarian doppler intravaginally to r/o torsion. I have been told by a radiologist that the ovary is fed by both the uterine and ovarian arteries. To tell the difference is to recognize the diastolic notch in the uterine art. Just because we see uterine arterial flow within the ovary does not mean that the ovarian artery is not torsed. Generally if I see ovarian flow from the ovarian artery in the ovsry, then it's safe to say there's no torsion. Please enlighten me if this is not correct. Suzy Hettena RDMS

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