Ultrasound characteristics of hydrosalpinx

Objectives: To describe the ultrasound findings of hydrosalpinx as well as to identify the main features that could help distinguish between hydrosalpinx and other adnexal masses. Methods: Based on the histological diagnosis of hydrosalpinx, 30 women (23 premenopausal and 7 postmenopausal) have been included in the study. These women with at least one persistent adnexal mass preoperatively underwent transvaginal gray-scale and color Doppler ultrasound examination, using standardized terms and definitions. The ultrasound findings as well as data from the personal history have been analyzed retrospectively. Results: The masses observed during the ultrasound examination were smooth tubular structures, with mean maximum diameter 63.0 ± 7.25 mm, giving the impression that they originate from the tube (73%). 87% of the masses (26/30) were unilocular, anechoic, poorly vascularized formations (67% without blood flow; 23% with minimal blood flow in the lesion; 7% moderately strong flow; and 3% highly vascularized lesion). The internal cyst wall was regular in 63.3% while only one papillary projection (6 × 5 × 5 mm) was identified in one mass. The main ultrasound finding was the presence of an incomplete septum in 18 of the 30 masses (60%), while septa have been observed in 27% of themasses. Based on the data collected from the personal history of the women, 70% previously underwent an abdominal operation, indicating a possible close relationship between operation and the subsequent formation of hydrosalpinx. Conclusions: We conclude that the sonographic appearance of incomplete septum in an anechoic mass with smooth tubular shape and poor vascularization facilitates discrimination between hydrosalpinx and other adnexal masses. Additionally, a personal history of previous abdominal operations further supports the preoperative diagnosis of hydrosalpinx.