Analysis on the reasons of contrast agent reflux during transvaginal real-time three-dimensional hysterosalpingo-contrast sonography

Abstract

Objective To discuss the possible reasons of contrast agent reflux during transvaginal real-time three-dimensional hysterosalpingo-contrast sonography(TVS RT-3D-HyCoSy), and in order to provide scientific evidences for reducing the contrast agent reflux. Methods The sonographic features of contrast reflux were observed in the images of 167 infertile patients who underwent TVS RT-3D-HyCoSy, and the association of the incidence rate of the reflux with tubal patency, the types of infertility, endometrial thickness, menstrual clean days, abnormal uterine cavity, the history of intrauterine operations, pelvic operations and ectopic pregnancies were analyzed. Results The incidence rate of the reflux during TVS RT-3D-HyCoSy was 41.3%. The incidence rates of reflux in unilateral patency and bilateral obstruction were 4.929 and 9.215 times of that of bilateral patency respectively. The incidence rate of reflux in the secondary infertility cases was significantly higher than that of primary ones(P<0.05). Logistic regression analysis demonstrated that the reflux is associated with the tubal patency, the endometrial thickness and the history of intrauterine operations, and none of the other factors. Conclusions TVS RT-3D-HyCoSy could differentiate the images of reflux better; the proper timing of the contrast examination and avoiding the damage of endometrium would reduce the incidence of the reflux. Key words: Ultrasonography, real-time three-dimensional; Microbubbles; Hysterosalpingography; Reflux