Ovarian torsion (OT) represents a severe gynecological emergency in female pediatric patients, necessitating immediate surgical intervention to prevent ovarian ischemia and preserve fertility. Prompt diagnosis is, therefore, paramount. This retrospective study set out to assess the utility of combined clinical, ultrasound, and laboratory features in diagnosing OT. The authors included 326 female pediatric patients aged under 14 years who underwent surgical confirmation of OT over a five-year period. Logistic regression analysis was employed to pinpoint factors linked with OT, and the authors compared clinical presentation, laboratory results, and ultrasound characteristics between patients with OT (OT group) and without OT (N-OT group). The authors conducted receiver operating characteristic (ROC) curve analysis to gauge the predictive capacity of the combined features. Among 326, OT was confirmed in 24.23 % (79 cases) of the patients. The OT group had a higher incidence of prenatal ovarian masses than the N-OT (22 cases versus 7 cases) ( < 0.0001). Similarly, the authors observed significant differences in the presence of lower abdominal pain, suspected torsion on transabdominal ultrasound, and a high neutrophil-lymphocyte ratio (NLR > 3) between the OT and non-OT groups (p ˂ 0.05). Furthermore, when these parameters were combined, the resulting area under the curve (AUC) was 0.868, demonstrating their potential utility in OT diagnosis. This study demonstrates a prediction model integrating clinical, laboratory, and ultrasound findings that can support the preoperative diagnosis of ovarian torsion, thereby enhancing diagnostic precision and improving patient management. Future prospective studies should concentrate on developing clinical predictive models for OT in pediatric patients.

中文翻译：

---

诊断儿童卵巢扭转的关键临床预测因素

卵巢扭转 (OT) 是女性儿科患者的严重妇科急症，需要立即进行手术干预，以防止卵巢缺血并保留生育能力。因此，及时诊断至关重要。这项回顾性研究旨在评估结合临床、超声和实验室特征在诊断 OT 中的效用。作者纳入了 326 名 14 岁以下的女性儿科患者，她们在五年内接受了 OT 手术确认。采用逻辑回归分析来查明与 OT 相关的因素，作者比较了 OT 患者（OT 组）和未患 OT 患者（N-OT 组）的临床表现、实验室结果和超声特征。作者进行了受试者工作特征 (ROC) 曲线分析，以衡量组合特征的预测能力。 326 例患者中，24.23%（79 例）确诊为 OT。 OT 组产前卵巢肿块的发生率高于 N-OT 组（22 例 vs 7 例​​）（< 0.0001）。同样，作者观察到 OT 组和非 OT 组在下腹疼痛、经腹超声检查疑似扭转以及中性粒细胞与淋巴细胞比率较高 (NLR > 3) 方面存在显着差异 (p ˂ 0.05)。此外，当这些参数组合起来时，所得的曲线下面积 (AUC) 为 0.868，证明了它们在 OT 诊断中的潜在实用性。这项研究展示了一种整合临床、实验室和超声检查结果的预测模型，可以支持卵巢扭转的术前诊断，从而提高诊断精度并改善患者管理。未来的前瞻性研究应集中于开发儿科患者 OT 的临床预测模型。