Assessment of tubal fimbria patency by combination of transvaginal four-dimensional hysterosalpingo-contrast sonography with uterine tubal liquid poking

Abstract

Objective To investigate the clinical value of combination of transvaginal four-dimensional hysterosalpingo-contrast sonography(TVS 4D-HyCoSy) with uterine tubal liquid poking in assessment tubal fimbria patency. Methods Sixty-two female infertile patients with obstruction at tubal fimbria, or partial obstruction with pelvic adhesion were included.All of them were underwent 4D-HyCoSy as well as uterine tubal liquid poking, and were followed with laparoscopic chromopertubation (LPC) using Methylene blue in three months. Results Comparing with laparoscopy, the total coincidence rate of 4D-HyCoSy to assess the tubal fimbria patency was 94.3%, with the sensitivity of 90.1% and specificity of 94.1%. Imaging results showed that the obstruction at tubal fimbria, uncircle-like wrapping contrast medium can be seen around ovary accounted for 80%. The patent fallopian tube fimbria, circle-like wrapping of contrast medium can be observed around ovary accounted for 85.5%. Conclusions The combination of TVS 4D-HyCoSy with uterine tubal liquid poking is highly in accordance with LPC by providing real-time dynamic visualization on overflowing of contrast medium from tubal fimbria, as well as the pelvic adhesion surrounding ovaries. The 4D-HyCoSy can be the preferred method for assessment of tubal fimbria patency and pelvic adhesion surrounding ovaries with its advantages of accuracy, non-invasion and a good safety profile. Key words: Ultrasonography, three-dimensional; Hysterosalpingography; Fallopian tubal patency tests