{"paper_id":"1f1deac0-b406-4517-855c-99c778a3a6d4","body_text":"Vol.:(0123456789)1 3\nAbdominal Radiology (2021) 46:2985–2986 \nhttps://doi.org/10.1007/s00261-020-02901-z\nCLASSICS IN ABDOMINAL RADIOLOGY\nThe \"waist sign” of a dilated fallopian tube\nFrank Chen1 · Manoj K. Jain1 · Shweta Bhatt1 \nReceived: 15 September 2020 / Revised: 31 October 2020 / Accepted: 4 December 2020 / Published online: 2 January 2021 \n© The Author(s) 2021\n“Waist sign” refers to diametrically opposed indentations \nalong the walls of tubular cystic structure and has been lik -\nened in appearance to a human waist (Figs. 1, 2). An adnexal \ncystic lesion with positive waist sign and a tubular shape is \nconsidered pathognomonic for hydrosalpinx. Hydrosalpinx \nis a relatively common condition that occurs when the amp-\nullary segment of the fallopian tube becomes obstructed and \nthe tube becomes distended by accumulated secretions. The \nmost common cause of hydrosalpinx is sequela of prior pel-\nvic inflammatory disease, with less common causes includ-\ning tubal ligation, endometriosis, and adhesions resulting \nfrom pelvic surgeries, tubal pregnancy, and tubal neoplasm \n[1]. Most patients with hydrosalpinx are asymptomatic, but \nsome patients may present with recurrent pelvic pain or \ninfertility [2 ]. It is important to differentiate hydrosalpinx \nfrom other adnexal cystic lesions, especially ovarian cystic \nneoplasms, as hydrosalpinx is often treated conservatively \nif asymptomatic.\nThe waist sign was first described in hydrosalpinx on \nultrasound, but can also be seen on CT and MRI [3]. Besides \na positive waist sign and tubular shape, other imaging fea-\ntures on ultrasound that are suggestive of hydrosalpinx \ninclude incomplete septa that result from the fallopian tube \nfolding upon itself and thickened longitudinal folds that have \na “cogwheel” appearance when imaged in cross-section, \nseen with chronic pelvic inflammatory disease [4].\n * Shweta Bhatt \n bhattshweta@hotmail.com\n1 Department of Radiology, Mayo Clinic, 4500 San Pablo Rd \nS, Jacksonville, FL 32224, USA\n\n2986 Abdominal Radiology (2021) 46:2985–2986\n1 3\nCompliance with ethical standards \nConflict of Interest All authors, Frank Chen, Manoj K Jain, and Shwe-\nta Bhatt, declare that they have no conflicts of interest.\nOpen Access This article is licensed under a Creative Commons Attri-\nbution 4.0 International License, which permits use, sharing, adapta-\ntion, distribution and reproduction in any medium or format, as long \nas you give appropriate credit to the original author(s) and the source, \nprovide a link to the Creative Commons licence, and indicate if changes \nwere made. The images or other third party material in this article are \nincluded in the article’s Creative Commons licence, unless indicated \notherwise in a credit line to the material. If material is not included in \nthe article’s Creative Commons licence and your intended use is not \npermitted by statutory regulation or exceeds the permitted use, you will \nneed to obtain permission directly from the copyright holder. To view a \ncopy of this licence, visit http://creat iveco mmons .org/licen ses/by/4.0/.\nReferences\n 1. Kim MY, Rha SE, Oh SN, et al. (2009) MR imaging find-\nings of hydrosalpinx: a comprehensive review. Radiographics \n29(2):495-507.\n 2. Rezvani M, Shaaban AM. (2011) Fallopian tube disease in the \nnonpregnant patient. Radiographics 31(2):527-548.\n 3. Patel MD, Acord DL, Young SW. (2006) Likelihood ratio of \nsonographic findings in discriminating hydrosalpinx from other \nadnexal masses. AJR Am J Roentgenol 186(4):1033-1038.\n 4. Brown DL, Dudiak KM, Laing FC. (2010) Adnexal masses: US \ncharacterization and reporting. Radiology 254(2):342-354.\nPublisher’s Note Springer Nature remains neutral with regard to \njurisdictional claims in published maps and institutional affiliations.\nFig. 1  Color Doppler ultra-\nsound image of the right adnexa \nshows a tubular, avascular, \ncystic structure with a “waist” \n(arrows), consistent with a \nhydrosalpinx\nFig. 2  Diagrammatic illustration of a dress with a conspicuous waist","source_license":"CC-BY-4.0","license_restricted":false}