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Fallopian tube

The fallopian tube, also known as the uterine tube or oviduct, is a paired tubular structure of the female reproductive system. Each tube extends laterally from the uterine cornu toward the ovary, serving as the site of fertilization and transport of the ovum. The tube plays a vital role in reproduction and is clinically significant in conditions such as ectopic pregnancy, salpingitis, and tubal infertility.

Synonyms

  • Uterine tube

  • Oviduct

  • Tubal structure of female reproductive tract

Parts, Course, and Structure

  • Infundibulum: Funnel-shaped distal end near the ovary, with finger-like fimbriae that capture the ovulated oocyte

  • Ampulla: Longest and widest part of the tube, where fertilization usually occurs

  • Isthmus: Narrow, thick-walled medial segment adjacent to the uterus

  • Intramural (interstitial) part: Short segment that passes through the uterine wall and opens into the uterine cavity

The tube measures about 10–12 cm in length and is lined by ciliated epithelium, aiding in the propulsion of the ovum toward the uterus.

Relations

  • Medially: Continuous with the uterine cavity at the uterine cornu

  • Laterally: Opens into the peritoneal cavity near the ovary

  • Superiorly: Related to the broad ligament (mesosalpinx encloses the tube)

  • Inferiorly: Lies above the ovary and pelvic vessels

Function

  • Transports the ovum from the ovary to the uterus

  • Serves as the site of fertilization (ampullary region)

  • Provides a nutritive and protective environment for the zygote during early development

  • Acts as a conduit between the peritoneal cavity and uterine cavity

Clinical Significance

  • Ectopic pregnancy: Commonly occurs in the ampulla; life-threatening if ruptured

  • Salpingitis and Pelvic Inflammatory Disease (PID): Inflammation of the tube leading to infertility or abscess formation

  • Hydrosalpinx or pyosalpinx: Dilatation due to fluid or pus accumulation

  • Tubal occlusion: A cause of female infertility; assessed during hysterosalpingography or laparoscopy

  • Surgical relevance: Site for procedures like salpingectomy, salpingostomy, or tubal ligation

MRI Appearance

T1-weighted images:

  • Normal tube is thin and often not well visualized

  • Fluid within the tube shows low signal intensity

  • Hematosalpinx (blood in the tube) may show high signal intensity

T2-weighted images:

  • Tubal fluid (hydrosalpinx) appears bright

  • Wall of the tube shows intermediate signal intensity

  • Inflamed or thickened tubes may appear hyperintense compared to baseline

STIR (Short Tau Inversion Recovery):

  • Enhances detection of inflamed or fluid-filled tubes as bright signal

  • Surrounding edema or pelvic inflammation also appears bright

T1 Fat-Sat Post-Contrast:

  • Normal tube shows little to no enhancement

  • Inflamed or neoplastic tubes demonstrate wall thickening and heterogeneous enhancement

  • Abscessed tube or tubo-ovarian complex shows rim enhancement with non-enhancing center

CT Appearance

Non-Contrast CT:

  • Normal tubes are rarely visualized unless fluid-filled

  • Dilated tubes (hydrosalpinx, pyosalpinx, hematosalpinx) appear as serpiginous or tubular fluid-density structures in the adnexa

Post-Contrast CT:

  • Inflamed tubes show wall thickening and enhancement

  • Tubo-ovarian abscess shows rim enhancement with central low attenuation

  • Neoplastic involvement shows irregular enhancing masses involving the tube

MRI image

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MRI image

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CT images

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CT images

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