Hydrosalpinx gynecological ultrasound
Ultrasound
- thin- or thick-walled (in chronic cases)
- elongated or folded, tubular, C-shaped, or S-shaped fluid-filled structure
- distinct from the uterus and ovary.
Longitudinal folds that are present in a normal fallopian tube may become thickened in the presence of a hydrosalpinx. The folds may produce a characteristic “cogwheel” appearance when imaged in cross-section. These folds are pathognomonic of a hydrosalpinx. Indentations on the opposite sides of the wall is referred to as the waist sign which is a strong predictor of hydrosalpinx. The waist sign in combination with a tubular-shaped cystic mass has been found to be pathognomonic of a hydrosalpinx 9. Incomplete septa may also give a “beads on a string” sign.
Sometimes the dilated fallopian tube may not show longitudinal folds. If the elongated nature of these folds is not noted, they may be mistaken for mural nodules of an ovarian cystic mass. A significantly scarred hydrosalpinx may present as a multilocular cystic mass with multiple septa (often incomplete) creating multiple compartments. These septa are generally incomplete, and the compartments can be connected. However, with more pronounced scarring, differentiation from an ovarian mass may not be possible
