Objective: Adnexal torsion (AT) is an ischemic process that evolves over time till necrosis. Unfortunately, there are no investigations or intraoperative findings to predict adnexal necrosis. The question of this study is, “Can MRI detect necrotic or non-necrotic adnexa?” Detorsion of viable twisted adnexa can preserve a functioning ovary. Design: Prospective study. Patients and Methods: Thirteen patients of suspected AT on the basis of clinical, ultrasound, and color Doppler were immediately transferred for magnetic resonance imaging (MRI) to be done and then emergency laparoscopy was planned. After laparoscopic confirmation of AT, the first step was to untwist the adnexa and assess the potential for tissue recovery; then, adnexectomy was carried out only when the adnexa was necrotic and there was no recovery after detorsion. Results: MRI suspected hemorrhagic infarction in only one case. Adnexectomy was performed for the same case of suspected MRI necrosis. Follow up of the 12 detorsion cases revealed normal ovarian functions. The main limitation of this study is the low number of studied patients due to relative rarity of AT. Conclusion: MRI may be a promising tool to detect viability adnexa, and the decision of detorsion operation can be done to preserve ovarian function. Many studies still need to support this conclusion. (J GYNECOL SURG 31:336)
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