A pyosalpinx refers to a situation where the Fallopian tube becomes filled (and often distended) with pus.
A pyosalpinx often tends to be a complication of background pelvic inflammatory disease (PID) where inflammation results in tubal and peritubal adhesions with superimposed obstruction of the fimbrial end. It can be a component of a tubo-ovarian abscess. Being unable to drain, the fallopian tube distends with pus resulting in a pyosalpinx.
A pyosalpinx may be seen as a thickened fallopian tube and may or may not be associated with debris containing tubal distention.
It may be seen seen as a dilated serpantine / tubular stucture in the pelvis. Low-level echoes are more commonly encountered in a pyosalpinx due to the higher protein content of the debris within the tube 4,6.
Morphological appearances of a pyosalpinx can sometimes be be indistinct from a simple uncomplicated tubal dilatation (hydrosalpinx) 1. As opposed to a simple hydrosalpinx, the tube wall may appear thickened 3 and have hyper-enhancing tubal walls with surrounding inflammation.
Signal characteristics within the tubular lumen have been described as 5
- T1 - variable due to varying protein content
- T2 - often of high signal
- T1 contrast - thick rim enhancement
- DWI/ADC - avid internal diffusion restriction
- 1- Hamm B, Krestin G, Laniado M et-al. MR Imaging of the Abdomen and Pelvis. Thieme Medical Pub. (2009) ISBN:3131455918. Read it at Google Books - Find it at Amazon
- 2- Skucas J. Advanced imaging of the abdomen. Springer Verlag. (2006) ISBN:1852339926. Read it at Google Books - Find it at Amazon
- 3- Tukeva TA, Aronen HJ, Karjalainen PT et-al. MR imaging in pelvic inflammatory disease: comparison with laparoscopy and US. Radiology. 1999;210 (1): 209-16. Radiology (full text) - Pubmed citation
- 4- Williams PL, Laifer-narin SL, Ragavendra N. US of abnormal uterine bleeding. Radiographics. 23 (3): 703-18. doi:10.1148/rg.233025150 - Pubmed citation
- 5- Rezvani M, Shaaban AM. Fallopian tube disease in the nonpregnant patient. Radiographics. 31 (2): 527-48. doi:10.1148/rg.312105090 - Pubmed citation
- 6- Benjaminov O, Atri M. Sonography of the abnormal fallopian tube. AJR Am J Roentgenol. 2004;183 (3): 737-42. AJR Am J Roentgenol (full text) - Pubmed citation
- 7- Semelka RC. Abdominal-Pelvic MRI. Wiley-Blackwell. (2010) ISBN:0470487755. Read it at Google Books - Find it at Amazon
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