Fig. 10

Pelvic inflammatory disease with pyosalpinx on MRI. This patient presented to the emergency department with pyrexia, lower abdominal pain and diarrhoea. a Sagittal T2 image of the pelvis demonstrates multiple fluid-filled cystic structures within the right adnexa (black arrows). The complex cyst is thick walled and there is adjacent fat stranding. b Axial T2 image demonstrates bilateral tubo-ovarian abcesses. c Axial T1 fat-saturated image following gadolinium administration demonstrates low signal intensity within the pus-filled cavities and marked enhancement of the inflammatory walls. The imaging appearances may overlap with ovarian malignancy but the clinical presentation is of sepsis