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Ultrasound signs of normal fallopian tubes
Medical expert of the article
Last reviewed: 04.07.2025
Fallopian tubes
It is difficult to visualize normal fallopian tubes using ultrasound. The fallopian tubes are quite variable in size and position, and it is difficult to detect tubal pathology unless there is significant localized change, such as isolated enlargement of one of the tubes. If the tubes are filled with fluid, they are difficult to differentiate from intestinal loops, although peristalsis should be detected in the intestine, while the fallopian tubes do not change position for several hours. Tubal obstruction is not detected sonographically until there is tube dilation above the site of obstruction.
Enlargement of a portion of the fallopian tube may occur in ectopic pregnancy; in this case, a fluid-containing tubular, anechoic (or mixed echogenicity) structure is determined, located near the uterus. However, pyosalpinx (of tuberculous or pyogenic genesis) looks very similar. Additional clinical information is needed to differentiate hydro- and pyosalpinx.
Varicose veins of the pelvis
Pelvic vein dilation may be accompanied by pain syndrome, especially in the premenstrual period. Echography reveals multiple anechoic, tubular structures around the uterus and sometimes between the uterus and the bladder. Sometimes a single dilated vein is detected, and it may be mistaken for hydrosalpinx. For differential diagnosis in this case, it is recommended to examine the patient in a supine position with her head down. In this case, the dilated vein will empty, and the hydrosalpinx will not change its size.
There are many reasons for the appearance of formations in the pelvis. Ultrasound does not always differentiate these formations. It is also necessary to remember that:
- A large formation in the small pelvis can cause compression of the ureter with the development of hydronephrosis. If a formation is detected in the small pelvis, the kidneys must be examined to exclude hydronephrosis.
- Intestinal masses (of inflammatory or parasitic origin) may be mistaken for pelvic masses. Try to determine the presence or absence of peristalsis.
- It is recommended to use cleansing enemas to remove food debris from the intestines or to introduce fluid into the rectum to clarify the anatomy of the pelvic organs.