Cobra head sign – an old sign but new finding

Cobra head sign – an old sign but new finding

Kalsi S.S., Chua N., Khan S., Mahmood I.

Purpose. To describe the appearances of the ‘cobra head sign’ in a case of hydrosalpinx of the uterus.
1 - Basildon University Hospital. Essex, UK.
2 - London North West Healthcare NHS Trust. London, UK.










Material and Methods. A 35-year old woman presented with chronic abdominal pain and diarrhoea to the general medicine clinic. She had symptoms on going for several years and as part of her radiology work up she had several CT and MRI scans of the abdomen. During the caesarean section in 2010 she had an incidental pelvic uterine teratoma which was also removed. After this surgery in 2010 she underwent bilateral tubal ligation for sterilisation purposes. Results. The T2 weighted MRI of the pelvis shows high signal intensities in the uterus adjacent to the ostium of the fallopian tubes. The bilateral high signal foci are spherical and are in continuation with the dilated fallopian tubes, also demonstrating internal high T2 signal suggestive of hydrosalpinx. The rest of the endometrium, myometrium gives expected normal signal. Conclusion. To our knowledge there are no previous cases in the literature which describe this appearance in the uterus. The cobra head sign is well documented in cases of ureterocele and the mechanism, although slightly different, remains as a result of partial obstruction. Ureteroceles are formed by a prolapse of the mucosa in the distal ureter through the ureterovesical orifice into the bladder.


Keywords: MRI, pelvis, uterus, cobra head sign, hydrosalpinx of the uterus.


Corresponding author: Mahmood I., Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: : Kalsi S.S., Chua N., Khan S., Mahmood I. Сobra head sign – an old sign but new finding. REJR. 2017; 7 (1):81-85. DOI:10.21569/2222-7415-2016-6-4-81-85.

Received: 12.08.2016 Accepted:17.12.2017