Tubal patency evaluation: feasibility of new automated three dimensional sonographic method

Abstract

OBJECTIVE: To evaluate the feasibility of a new automated three dimensional contrast-enhanced ultrasound technology called “Coded Contrast Imaging” (3D CCI-GE Healthcare) in the evaluation of tubal patency and visualization of tubal course.DESIGN: Patients undergoing transvaginal hystero-salpingo-contrast-sonography (TVS HyCoSy) with automated 3D CCI were prospectively evaluated.MATERIALS AND METHODS: Sixtytwo patients of reproductive age underwent automated 3D CCI HyCoSy. The CCI allows the detection of an ultrasound contrast agent in the tube by discriminating the harmonic response of contrast bubbles from the echoes of other tissues. 3D TVS allows the visualization of tubal course. In order to evaluate the feasibility of this method we considered first the tubal patency and the 3D visualization of tubal course after two consecutive contrast agent injections. The visualization with CCI of the contrast agent around the ovaries, the need for more than one fluid injection to assess tubal patency, the detection in 2D real time of the bubbles movement around the ovaries, and the side effects and pain during and after the procedure were assessed.RESULTS: Sixtytwo patients underwent automated 3D CCI HyCoSy; 50 women showed bilateral tubal patency and 12 a tubal occlusion (4 cases bilateral, 8 unilateral). The 3D tubal course automated reconstruction was achieved in 41cases (66%) after the first contrast injection, while in other 15 cases a second injection was needed, for a total of 56(90%) 3D tubal imaging. For the 108 patent tubes, in 101 cases CCI clearly showed the contrast agent around the omolateral ovary. 2D realtime evaluation was performed in all cases to confirm tubal status and it was helpful to assess tubal patency in those 6 patients in whom 3D reconstruction wasn't good enough to achieve a diagnosis.CONCLUSIONS: Automated 3D-CCI HyCoSy allows for a reliable assessment of tubal patency in 90% of cases. Automated 3D volume acquisition allows less experienced operators to easily evaluate the tubal course. OBJECTIVE: To evaluate the feasibility of a new automated three dimensional contrast-enhanced ultrasound technology called “Coded Contrast Imaging” (3D CCI-GE Healthcare) in the evaluation of tubal patency and visualization of tubal course. DESIGN: Patients undergoing transvaginal hystero-salpingo-contrast-sonography (TVS HyCoSy) with automated 3D CCI were prospectively evaluated. MATERIALS AND METHODS: Sixtytwo patients of reproductive age underwent automated 3D CCI HyCoSy. The CCI allows the detection of an ultrasound contrast agent in the tube by discriminating the harmonic response of contrast bubbles from the echoes of other tissues. 3D TVS allows the visualization of tubal course. In order to evaluate the feasibility of this method we considered first the tubal patency and the 3D visualization of tubal course after two consecutive contrast agent injections. The visualization with CCI of the contrast agent around the ovaries, the need for more than one fluid injection to assess tubal patency, the detection in 2D real time of the bubbles movement around the ovaries, and the side effects and pain during and after the procedure were assessed. RESULTS: Sixtytwo patients underwent automated 3D CCI HyCoSy; 50 women showed bilateral tubal patency and 12 a tubal occlusion (4 cases bilateral, 8 unilateral). The 3D tubal course automated reconstruction was achieved in 41cases (66%) after the first contrast injection, while in other 15 cases a second injection was needed, for a total of 56(90%) 3D tubal imaging. For the 108 patent tubes, in 101 cases CCI clearly showed the contrast agent around the omolateral ovary. 2D realtime evaluation was performed in all cases to confirm tubal status and it was helpful to assess tubal patency in those 6 patients in whom 3D reconstruction wasn't good enough to achieve a diagnosis. CONCLUSIONS: Automated 3D-CCI HyCoSy allows for a reliable assessment of tubal patency in 90% of cases. Automated 3D volume acquisition allows less experienced operators to easily evaluate the tubal course.