I did not speak of phases of twisting, as this is all ischemic phase.
Total obstruction is a no flow situation. This leads to the problem of
documenting the absence of something - much harder than seeing it. This
is exactly the same difference between a basic & targeted scan...
JimS
--
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
>>> nattu@vsnl.com 6/15/2005 5:42:26 AM >>>
Dear Jim.
Very interesting reading.......your mail. Esp. the Low indices
during
the initial phase of "twisting".
How often do you trace the Inf. pelvic vessels under normal
circumstances.?
Thanks for the details.
LN.
Dr. Latha Natarajan,
Physician and Sonologist,
Bangalore,
India.
>----- Original Message -----
From: "James Smeltzer" <James.Smeltzer@wellstar.org>
To: "Multiple recipients of list ULTRASOUND"
<ultrasound@dns.obgyn.net>
Sent: Tuesday, June 14, 2005 9:33 PM
Subject: Re: Uterine vs ovarian
> Hi,
>
> 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
>
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