Presentation
Pelvic pain, negative B-hCG.
Patient Data
Dilated serpiginous tubular structures are noted on either side of the uterus in favor of dilated fallopian tubes. The dilated tubes' contents show high signal intensity on T1WI and relatively low signal intensity on T2WI. After contrast injection, no solid enhancing component could be detected.
Two 20 mm and 13 mm intramural myomas are seen at the uterine body and fundus, respectively.
Endometrial thickness is 5 mm, and the junctional zone is intact. Some T1W hyper signal foci are seen at the endometrial cavity in favor of bloody products.
A 16 mm defect is seen at the abdominal wall of LLQ with herniation or omental fat.
Case Discussion
Features on MR images are compatible with bilateral fallopian tubes hematosalpinx, which refers to intraluminal blood within the fallopian tubes, and in a woman with a negative B-hCG, consider endometriosis.