J Korean Soc Ultrasound Med.  2009 Dec;28(4):231-239.

Diagnostic Role of Hyperechoic Fatty Tissue at Ultrasonography in Women with Acute Pelvic Pain

• Park SJ
• Yi BH
• Lee HK
• Hong HS
• Kim HC

Abstract

PURPOSE
The aim of this study was to determine whether hyperechoic fatty tissue (HFT) at transabdominal and transvaginal ultrasonography in women with acute pelvic pain has a diagnostic role.
MATERIALS AND METHODS
We studied 201 women (mean age, 32 years) with acute pelvic and lower abdominal pain; we performed ultrasonography (US) in all them. Of the 201, 94 with gynecological problems were included., They were divided into two groups: with pelvic inflammatory disease (PID; n = 45) and without PID (n = 49). We evaluated the presence and distribution of HFT and its role in differential diagnosis between PID and non-PID groups.
RESULTS
We found, using US, HFT in 36/45 (80%) patients with PID by US. Of the 36, single-center HFT was observed in 12/36 (33.3%) patients and multicentric HFT was detected in 24/36 (66.7%). HFT was present adjacent to inflammatory foci, tuboovarian abscesses or inflamed salpinx in 30 women; HFT was present outside the pelvic cavity in 24. Among the latter 24, HFT was present only in the lower abdomen, and not in the pelvic cavity in 6. In the non-PID group, HFT was found in the lower abdomen and pelvic cavity in 7 women. Four of the seven were misdiagnosed with PID. One of seven women with a hemorrhagic corpus luteal cyst rupture with underlying PID and two with ectopic pregnancy with HFT were correctly diagnosed.
CONCLUSION
The presence of HFT may be a reliable US finding for the diagnosis of PID. HFT distinguishes PID from other acute gynecological problems.

Keyword

Pelvis; Ultrasound; Genital/Reproductive; Inflammation Hemorrhage

MeSH Terms

Abdomen
Abscess
Adipose Tissue
Diagnosis, Differential
Fallopian Tubes
Female
Humans
Pelvic Inflammatory Disease
Pelvic Pain
Pelvis
Pregnancy
Pregnancy, Ectopic
Rupture