Non-neoplastic diseases of the fallopian tube: MR imaging with emphasis on diffusion-weighted imaging

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Abstract

Objective

We illustrate the magnetic resonance imaging (MRI) features of non-neoplastic tubaric conditions.

Background

A variety of pathologic non-neoplastic conditions may affect the fallopian tubes. Knowledge of their imaging appearance is important for correct diagnosis. With recent advances in MRI, along with conventional MR sequences, diffusion-weighted imaging (DWI) sequences are available and may improve lesion characterization by discriminating the nature of the content of the dilated tube. Tubal fluid with low signal intensity on T1-weighted images, high signal intensity on T2-weighted images and no restricted diffusion on DWI is indicative of hydrosalpinx. Content with high signal intensity on T1-weighted images and restricted diffusion on DWI is suggestive of hematosalpinx associated with endometriosis or tubal pregnancy. A dilated tube with variable or heterogeneous signal intensity content on conventional MR sequences and restricted diffusion on DWI may suggest a pyosalpinx or tubo-ovarian abscess. We describe morphological characteristics, MR signal intensity features, enhancement behaviour and possible differential diagnosis of each lesion.

Conclusion

MRI is the method of choice to study adnexal pelvic masses. Qualitative and quantitative functional imaging with DWI can be of help in characterization of tubaric diseases, provided that findings are interpreted in conjunction with those obtained with conventional MRI sequences.

Teaching Points

• Nondilated fallopian tubes are not usually seen on MR images.

• MRI is the method of choice to characterize and localize utero-adnexal masses.

• MRI allows characterization of lesions through evaluation of the fluid content’s signal intensity.

• DWI in conjunction with conventional MRI sequences may improve tissue characterization.

• Pelvic inflammatory disease is the most common tubal pathology.

Related collections

Most cited references 74

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Spin Diffusion Measurements: Spin Echoes in the Presence of a Time-Dependent Field Gradient

E. O. Stejskal, J. E. Tanner (1965)

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Pearls and pitfalls in diagnosis of ovarian torsion.

Hannah Chang, Shweta Bhatt, Vikram Dogra (2024)

Ovarian torsion is defined as partial or complete rotation of the ovarian vascular pedicle and causes obstruction to venous outflow and arterial inflow. Ovarian torsion is usually associated with a cyst or tumor, which is typically benign; the most common is mature cystic teratoma. Ultrasonography (US) is the primary imaging modality for evaluation of ovarian torsion. US features of ovarian torsion include a unilateral enlarged ovary, uniform peripheral cystic structures, a coexistent mass within the affected ovary, free pelvic fluid, lack of arterial or venous flow, and a twisted vascular pedicle. The presence of flow at color Doppler imaging does not allow exclusion of torsion but instead suggests that the ovary may be viable, especially if flow is present centrally. Absence of flow in the twisted vascular pedicle may indicate that the ovary is not viable. The role of computed tomography (CT) has expanded, and it is increasingly used in evaluation of abdominal pain. Common CT features of ovarian torsion include an enlarged ovary, uterine deviation to the twisted side, smooth wall thickening of the twisted adnexal cystic mass, fallopian tube thickening, peripheral cystic structures, and ascites. Understanding the imaging appearance of ovarian torsion will lead to conservative, ovary-sparing treatment.

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Diffusion-weighted imaging in the abdomen and pelvis: concepts and applications.

Aliya Qayyum (2009)

Diffusion-weighted magnetic resonance (MR) imaging allows the detection of focal solid and cystic lesions in the abdomen and pelvis and, if pitfalls are to be avoided, is most effectively used in conjunction with other imaging sequences. It is important to recognize that the strength of the diffusion sensitizing gradient (b value) can and should be adjusted to ensure optimal evaluation of the body region or organ being imaged, and that more than one b value is necessary for tissue characterization. The success of lesion detection and characterization largely depends on the extent of tissue cellularity because increased cellularity is associated with impeded diffusion, as indicated by a reduction in the apparent diffusion coefficient. It is also important to recognize that certain normal tissues such as the endometrium are highly cellular and as such demonstrate restricted diffusion, which should not be misinterpreted as disease. Impeded diffusion can also be seen in highly viscous cystic lesions such as abscesses. Diffusion-weighted imaging is an evolving technology with the potential to improve tissue characterization when findings are interpreted in conjunction with findings obtained with other conventional MR imaging sequences.

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Author and article information

Contributors

Pietro Valerio Foti: 0953782360 , pietrofoti@hotmail.com

Journal

Journal ID (nlm-ta): Insights Imaging

Journal ID (iso-abbrev): Insights Imaging

Title: Insights into Imaging

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Electronic): 1869-4101

Publication date (Electronic): 18 March 2016

Publication date PMC-release: 18 March 2016

Publication date Collection: June 2016

Volume: 7

Issue: 3

Pages: 311-327

Affiliations

[ ]Radiodiagnostic and Radiotherapy Unit, University Hospital “Policlinico-Vittorio Emanuele”, Via Santa Sofia 78, 95123 Catania, Italy

[ ]Department G.F. Ingrassia – Institute of Pathology, University of Catania, Catania, Italy

Article

Publisher ID: 484

DOI: 10.1007/s13244-016-0484-7

PMC ID: 4877350

PubMed ID: 26992404

SO-VID: 5fe6f5db-6729-4c1e-8823-b346d45168c7

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 24 November 2015

Date revision received : 26 February 2016

Date accepted : 3 March 2016

Custom metadata

ScienceOpen disciplines: Radiology & Imaging

Keywords: fallopian tube,magnetic resonance imaging,pelvic inflammatory disease,adnexal masses,diffusion-weighted imaging

Data availability:

ScienceOpen disciplines: Radiology & Imaging

Keywords: fallopian tube, magnetic resonance imaging, pelvic inflammatory disease, adnexal masses, diffusion-weighted imaging

Non-neoplastic diseases of the fallopian tube: MR imaging with emphasis on diffusion-weighted imaging

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Abstract

Objective

Background

Conclusion

Teaching Points

Related collections

Stroke MRI

Most cited references 74

Spin Diffusion Measurements: Spin Echoes in the Presence of a Time-Dependent Field Gradient

Pearls and pitfalls in diagnosis of ovarian torsion.

Diffusion-weighted imaging in the abdomen and pelvis: concepts and applications.

Author and article information

Contributors

Journal

Affiliations

Article

History

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Custom metadata

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