Patient's question:
The imaging results showed tubal inflammation, with tortuosity and thinning. During the Mid-Autumn Festival this year, I went to the hospital to get "Shutong San" and applied it for a month.Doctor's answer:
Methods for diagnosing tubo-ovarian inflammation1. Hysterosalpingography: In the chronic stage, the imaging findings show tubal spasm, obstruction, and adhesion with fluid accumulation.
(1) Spasm: The uterine horns are not filled, and the uterus appears as a round shadow.
(2) Complete obstruction.
2. Ultrasound examination:
(1) In cases of tubal hydrops, a typical anechoic area is observed, while in cases of tubal abscess, scattered echoes are seen within the anechoic area.
(2) With small amounts of fluid, long anechoic areas are seen within the tubes, with thickened and uneven walls; moderate fluid accumulation appears as sausage-shaped anechoic areas, with thin walls; large amounts of fluid form oval or round anechoic areas, with thin and smooth walls. Tubal effusion may sometimes appear in a segmental pattern.
(3) In cases of tubal ovarian cysts, the anechoic area extends into the ovary.
3. CT examination:
(1) Tubal effusion or tubal ovarian cysts cannot be differentiated from other cystic masses in most cases.
(2) Tubo-ovarian abscesses are more easily identified on CT if the diameter is >2 cm, appearing as heterogeneous density masses with smooth or spiculated margins, thick and irregular walls. The abscess wall shows more prominent enhancement after contrast administration compared to general cysts. The presence of gas within the cyst is helpful for diagnosis.
(3) The CT value is 0–15 HU for effusion and 15–40 HU for abscess.
Expert reminder: Before treating tubo-ovarian inflammation, women should thoroughly understand the condition of the tubal inflammation, including whether there is tubal adhesion, obstruction, or effusion, before proceeding with symptomatic treatment.