Ultrasound of Hydrosalpinx, Pyosalpinx & Tubo-ovarian Abscess

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Radiology Lectures | Radquarters

Daniel J. Kowal, MD

75 episodes

3 weeks ago

High-yield, educational radiology lectures utilizing a multimodality imaging approach including MRI, CT, ultrasound, radiography, and nuclear medicine. Lectures are presented in both didactic and quiz formats. These video podcasts are designed for radiology residents, fellows, and radiologists, as well as any student or practitioner interested in optimizing patient care through radiology. Visit www.radiologistHQ.com for more info and reference material.

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Medicine

Health & Fitness

Ultrasound of Hydrosalpinx, Pyosalpinx & Tubo-ovarian Abscess

Radiology Lectures | Radquarters

11 minutes 10 seconds

11 months ago

Ultrasound of Hydrosalpinx, Pyosalpinx & Tubo-ovarian Abscess

Ultrasound of Hydrosalpinx, Pyosalpinx & Tubo-ovarian Abscess
In this radiology lecture, we review the ultrasound appearance of hydrosalpinx, pyosalpinx and tubo-ovarian abscess!
Key teaching points include:

* Hydrosalpinx = Fluid-filled, blocked fallopian tube
* Hydrosalpinx causes: Pelvic inflammatory disease (most common), endometriosis, prior surgery, adhesions
* Hydrosalpinx US: Thin-walled, tubular structure filled with anechoic simple fluid. Dilated tube may fold upon itself forming tubular C-shaped or S-shaped cystic mass. Incomplete septations common
* With chronic hydrosalpinx, may see “beads-on-a-string” sign: Short, round, 2-3 mm projections seen along inner tubal walls in cross section = Flattened, fibrotic remnants of endosalpingeal folds. Don’t confuse with solid mural nodules
* O-RADS US v2022 management of hydrosalpinx = Imaging: None. Clinical: Gynecologist
* Pyosalpinx: Inflamed, blocked fallopian tube filled with purulent debris. Indicates pelvic inflammatory disease
* Pyosalpinx US: Thick-walled tubal structure filled with complex fluid. Like hydrosalpinx, typically conforms to a C or S-shape
* “Cogwheel” sign of pyosalpinx: Thickened endosalpingeal folds with surrounding tubal wall thickening. Typical of acute tubal inflammation
* Tubal wall hyperemia more common with pyosalpinx than hydrosalpinx
* Tubo-ovarian complex (TOC): With severe salpingo-oophoritis, ovary and tube adhere to each other. Can distinctly identify ovary from tube but cannot separate the two with transducer pressure. Tx: Antibiotics
* Tubo-ovarian abscess (TOA): As pelvic inflammatory disease progresses, complete or near-complete loss of adnexal architecture with pockets of purulent fluid develop. Multiloculated mass with septations, irregular margins, may be bilateral. Tx: Antibiotics, percutaneous drainage, surgery

To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4
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