Right pelvic pain and fever (temperature at 38.8 °C), leukocytosis at 12300 : mm3, CRP at 96 mg /L, ESR at 107 mm (1st hour)
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The right fallopian tube is distended and tortuous with fluid content of intermediate signal on T1WI, high signal on T2WI with rim enhancement on post-contrast sequences. DWI shows a high signal with corresponding low ADC, indicating a diffusion restriction. There is minimal peritoneal fluid in the pouch of Douglas.
This case demonstrates the MRI features of pyosalpinx.
It should be differentiated from a simple hydrosalpinx by the presence of:
- a thickened enhancing fallopian tube wall
- surrounding inflammatory changes
- restricted diffusion within the fallopian tube on DWI/ADC
The treatment is surgical.