CT Stone Search Can Visualize the Ovaries
Yes, a CT stone search will show the ovaries as part of the pelvic structures visualized during the examination. While the primary purpose of a CT stone search is to identify kidney stones, this imaging modality captures all anatomical structures in the abdomen and pelvis, including the ovaries.
Visualization of Ovaries on CT Stone Search
- CT stone search (non-contrast CT abdomen and pelvis) is the first-line imaging modality for diagnosing kidney stones with approximately 97% sensitivity and 95% specificity 1
- The ovaries are routinely visualized on CT scans of the abdomen and pelvis, including those performed for kidney stone evaluation
- CT imaging allows for visualization of:
- Normal ovarian tissue
- Ovarian abnormalities (when present)
- Surrounding pelvic structures
Ovarian Findings on CT
When the ovaries are visualized on a CT stone search, the following can be assessed:
- Normal ovarian size and appearance
- Presence of ovarian cysts or masses
- Abnormalities such as enlarged ovaries or adnexal masses 2
- Potential complications like ovarian torsion, which presents as an enlarged, featureless ovary with possible swirling of the vascular pedicle 2
Limitations of Ovarian Assessment on CT Stone Search
Despite the ability to visualize ovaries, there are important limitations to consider:
- Non-contrast CT (standard for stone protocol) provides less soft tissue detail than contrast-enhanced CT
- CT has limited accuracy for detailed adnexal mass characterization 2
- In some cases, ovaries may not be visualized due to:
- Patient factors (body habitus, bowel gas)
- Technical factors (motion artifact)
- Anatomical variations
A study examining non-visualization of ovaries found that when ovaries were not seen on CT, there was a high negative predictive value (100%) for absence of ovarian pathology, suggesting that non-visualization typically does not indicate disease 3.
When Additional Imaging May Be Needed
While CT stone search will show the ovaries, additional imaging may be warranted in certain scenarios:
- When gynecological pathology is suspected but CT findings are inconclusive 2
- For detailed characterization of ovarian or adnexal masses 2
- When endometrial abnormalities are suspected 4
In these cases, transvaginal ultrasound is often the preferred follow-up imaging modality due to its superior soft tissue resolution for gynecologic structures 2.
Clinical Implications
- Incidental ovarian findings on CT stone search should be noted and may require follow-up
- Normal-appearing ovaries on CT have high negative predictive value for ovarian pathology
- For suspected gynecological conditions, ultrasound remains the first-line imaging modality of choice 2
CT stone search protocols are optimized for stone detection rather than gynecologic evaluation, but they do provide visualization of the ovaries as part of the comprehensive abdominal and pelvic imaging.