Fig. 13
Tubo-ovarian abscess in a 53-year-old woman with acute abdominal pain and elevation of inflammatory markers such as VES and leucocytes. She has used intra-uterine devices (IUDs). (a) Axial and (b) sagittal T2-weighted images show a multilocular, cystic, pelvic mass with heterogeneous high signal intensity content on T2-weighted images (white arrows) in the left side of the pelvis. (c) Axial DW image (b = 800 s/mm2) demonstrates increased signal of the lesion (white arrow), a finding consistent with purulent content. (d) Axial and (e) sagittal contrast-enhanced fat-suppressed T1-weighted images show septal and thick rim enhancement in the mass (white arrows) and in the surrounding inflammatory stranding (*), a finding consistent with tubo-ovarian abscess. (f) Oblique sagittal MIP image (acquired about 15 min after contrast administration) shows mild dilatation of the renal pelvis and ureter (white arrowhead) due to the compression of tubo-ovarian abscess on the lower third of ureter