Cross-sectional imaging of acute gynaecologic disorders: CT and MRI findings with differential diagnosis—part II: uterine emergencies and pelvic inflammatory disease

Insights into Imaging

Table 2 MR imaging findings of PID. DWI diffusion-weighted imaging, ADC apparent diffusion coefficient

Tubo-ovarian disease	Morphology	T2	T1	Gd–T1	DWI	ADC	Differential diagnoses
Hydrosalpinx	Fluid filled thin-walled tubular structure	High	Low	No enhancement	Low	No restriction	- Multilocular cystic adnexal masses
Haematosalpinx	Dilated fallopian tube filled with blood products	Intermediate with dark thick rim, possible “shading sign” in endometriosis	High	Slight enhancement of the tubaric wall	High	Restriction	- Endometriosis - Ectopic Pregnancy - Adnexal torsion - Trauma - Malignancy
Acute salpingitis	Swollen fallopian tube with intramural inflammation	Wall thickening of the distended tube	Low	Wall enhancement	High signal of the wall	Restriction of the wall
Pyosalpinx	Bilateral, serpiginous or tubular structure with purulent content and possible fluid-debris levels	Iso-hyperintense	Variable	Enhancement of the thickened wall	High	Restriction
Tubo-ovarian abscess	Loss of the normal adnexal structure, formation of a solid-cystic pus-filled inflammatory mass	Heterogeneous high signal	Heterogeneous low signal	Septal and thick rim mucosal enhancement	High signal of the wall, septa and purulent content	Restriction of the wall, septa and purulent content	- Ovarian carcinoma - Primary fallopian tube carcinoma