{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:54:06Z","timestamp":1791309246332,"version":"4.3.1"},"reference-count":55,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Torsion of pedunculated subserosal uterine leiomyomas (TPSUL) is a rare but potentially severe condition that may require emergency surgery. This article aims to summarize the existing literature by presenting a systematic review and an illustrative case report. A total of 38 articles describing 42 cases of TPSUL were analyzed to identify recurring ultrasound features that may aid in preoperative diagnosis. The most frequently reported findings included a mean maximum diameter of approximately 10\u2009cm, increased size compared to prior scans (100%), heterogeneous echotexture (81%), regular borders (90%), and posterior or trans\u2010lesional acoustic shadows (94%). Additional common features were the presence of free pelvic fluid (57%), cystic areas with irregular margins and hypo\u2010anechoic content (55%), and absent (68%) or reduced (32%) vascularization of the lesion. A vascular pedicle was identified in 28% of cases, with signs of torsion in 12.5% and interruption of vascular flow at the pedicle base in 25%. The ultrasound features observed in our case, involving a 29\u2010year\u2010old pregnant patient at 21\u2009weeks' gestation, were consistent with those described in the literature. These findings support the role of ultrasound as a useful tool for the preoperative identification of TPSUL and lay the foundation for future diagnostic standardization.<\/jats:p>","DOI":"10.1002\/jcu.70292","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:01:46Z","timestamp":1780977706000},"page":"1981-1994","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound Characteristics of Twisted Pedunculated Subserosal Uterine Leiomyomas: A Case Report and a Systematic Review of the Literature"],"prefix":"10.1002","volume":"54","author":[{"given":"Maddalena","family":"Paoli","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna  Bologna 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