To explore the ultrasound imaging features of torsion of the pedicle of old ovarian cysts in infants and young children.

A retrospective study was conducted on 60 infants or young children under the age of 1 year who were diagnosed with ovarian cysts and admitted to the Children's Hospital Affiliated to Zhejiang University School of Medicine from January 2021 to July 2024. The ultrasound features and pathological manifestations were analyzed, and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound features for diagnosing torsion of the pedicle of old ovarian cysts were calculated to evaluate their diagnostic efficacy.

Out of 60 cases of ovarian cysts in infants and young children, 34 cases were old ovarian cyst torsion. The main ultrasound features and their diagnostic efficacy were: calcification (sensitivity: 67.6%; specificity: 80.8%; positive predictive value: 82.1%; negative predictive value: 65.6%); intracystic layering (sensitivity: 67.6%; specificity: 73.1%; positive predictive value: 76.7%; negative predictive value: 63.3%); and vortex sign-like pedicle structure (sensitivity: 47.1%; specificity: 100%; positive predictive value: 100%; negative predictive value: 59.1%). The diagnostic sensitivity, specificity, positive predictive value, and negative predictive value were 26.5%, 100%, 100%, and 51.0%, respectively, when the three characteristics were present simultaneously. The accuracy of ultrasound diagnosis of torsion of old ovarian cyst pedicle was 88.2% (30/34).

The torsion of the pedicle of old ovarian cysts in infants and young children has characteristic ultrasound manifestations, including calcification, intracystic layering, and vortex sign-like pedicle structures, which have good diagnostic value.