EURORAD ESR

Case 15389

Pelvic inflammatory disease with tubo-ovarian complex

Author(s)
Ana Coutinho Santos1, Mariana Horta2

1Radiology Department, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
2Radiology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
 
Patient
female, 25 year(s)
 
 
  • Figure 1
    Right adnexal region on TVUS
     

    A. A complex, dilated tubular and multiloculated lesion with thick irregular septa (arrows) and internal low-level echoes (*) is noted.

     
    Area of Interest: Pelvis; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Infection;

    B. Some locules demonstrate fluid/fluid layering (dashed arrow).

     
    Area of Interest: Pelvis; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 2
    Right adnexal lesion on TVUS
     

    Locules of the right adnexal lesion in detail on B-mode (A) and colour Doppler (B) on transvaginal ultrasound. The locules have thick walls (arrowhead on A) that show hypervascularity on Doppler evaluation (B).

     
    Area of Interest: Pelvis; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Infection;

    Locules of the right adnexal lesion in detail on B-mode (A) and colour Doppler (B) on transvaginal ultrasound. The locules have thick walls (arrowhead on A) that show hypervascularity on Doppler evaluation (B).

     
    Area of Interest: Pelvis; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 3
    Right adnexal region on TVUS.
     

    A. The right ovary (RO) is partially visualised and contiguous to the lesion (*).

     
    Area of Interest: Pelvis; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Infection;

    B. The same image on colour Doppler depicts hypervascularity of the right ovary.

     
    Area of Interest: Pelvis; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 4
    Left adnexal region on TVUS
     

    A. A complex cystic lesion with thick and irregular walls (arrow) and low-level echoes (*) in dependent position is noted adjacent to the left ovary (LO), which has normal dimension and structure.

     
    Area of Interest: Pelvis; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Infection;

    B. On colour Doppler, the left ovary has normal vascularity.

     
    Area of Interest: Pelvis; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 5
    Bilateral asymmetric adnexal complex lesions on contrast-enhanced CT (coronal view).
     

    A. The lesions are serpiginous and multiloculated with internal fluid (*) and enhancing walls and septations (arrows). Small amount of free fluid on right paracolic gutter (dashed arrow) is also depicted.

     
    Area of Interest: Pelvis; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Infection;

    B. The lesions are serpiginous and multiloculated with internal fluid (*) and enhancing walls and septations (arrows). Pelvic fat stranding (arroweads) is also depicted.

     
    Area of Interest: Pelvis; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Infection;
     
     
A. A complex, dilated tubular and multiloculated lesion with thick irregular septa (arrows) and internal low-level echoes (*) is noted.
 
B. Some locules demonstrate fluid/fluid layering (dashed arrow).
 
Locules of the right adnexal lesion in detail on B-mode (A) and colour Doppler (B) on transvaginal ultrasound. The locules have thick walls (arrowhead on A) that show hypervascularity on Doppler evaluation (B).
 
Locules of the right adnexal lesion in detail on B-mode (A) and colour Doppler (B) on transvaginal ultrasound. The locules have thick walls (arrowhead on A) that show hypervascularity on Doppler evaluation (B).
 
A. The right ovary (RO) is partially visualised and contiguous to the lesion (*).
 
B. The same image on colour Doppler depicts hypervascularity of the right ovary.
 
A. A complex cystic lesion with thick and irregular walls (arrow) and low-level echoes (*) in dependent position is noted adjacent to the left ovary (LO), which has normal dimension and structure.
 
B. On colour Doppler, the left ovary has normal vascularity.
 
A. The lesions are serpiginous and multiloculated with internal fluid (*) and enhancing walls and septations (arrows). Small amount of free fluid on right paracolic gutter (dashed arrow) is also depicted.
 
B. The lesions are serpiginous and multiloculated with internal fluid (*) and enhancing walls and septations (arrows). Pelvic fat stranding (arroweads) is also depicted.
 
 
 
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