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

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

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