Transvaginal Three-dimensional Hysterosalpingo-contrast Sonography Research Articles

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

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

Evaluation of Tubal Patency with Transvaginal Three-dimensional Hysterosalpingo-contrast Sonography.

To investigate diagnostic efficacy of transvaginal three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) in assessing tubal patency with chromolaporoscopy. A total of 157 infertile women underwent 3D-HyCoSy to evaluate tubal patency. Among these patients, 39 patients were also examined by chromolaporoscopy. The concordance of the two clinical assessment methods was analyzed by the Kappa coefficient test. Among the 306 oviducts examined by 3D-HyCoSy, 99 (32.4%) were patent, 126 (41.2%) partially obstructed, and 81 (26.5%) completely obstructed. Diagnostic results with 3D-HyCoSy were not statistically different from those obtained in the 39 women (78 oviducts) who also underwent chromolaporoscopy, and the two methods showed a high concordance (k=0.747, P=0.000). The 3D-HyCoSy procedure had a sensitivity of 84.8% (28/33), a specificity of 96.2% (25/26), and positive and negative predictive values of 93.3% (28/30) and 86.2% (25/29) respectively. Transvaginal 3D-HyCoSy can accurately reveal the spatial path and morphology of the oviduct and is a safe and effective method to evaluate tubal patency.

Value of three‐dimensional hysterosalpingo‐contrast sonography with SonoVue in the assessment of tubal patency

To investigate the accuracy of transvaginal three-dimensional hysterosalpingo-contrast sonography using SonoVue (3D SonoVue-HyCoSy) in the assessment of Fallopian tubal patency. We recruited 75 infertile patients undergoing 3D SonoVue-HyCoSy before standard diagnostic laparoscopy with chromotubation (lap and dye). Tubal patency was assessed by automated 3D coded contrast imaging (3D SonoVue-HyCoSy), and the findings were compared with the results of lap and dye. For detecting tubal patency among the 150 Fallopian tubes assessed, 3D SonoVue-HyCoSy had a sensitivity of 93.5%, specificity of 86.3%, positive and negative predictive values of 87.8% and 92.6%, respectively, and diagnostic accuracy of 90.0%. The test-positive rates of 3D SonoVue-HyCoSy vs lap and dye were not significantly different (82/150 vs 77/150, P > 0.05). 3D SonoVue-HyCoSy should be considered clinically valuable as a practical, non-invasive, primary investigatory tool for evaluating tubal patency.

Evaluation of the fallopian tube patency with transvaginal three-dimensional hysterosalpingo-contrast sonography

Objective To assess the feasibility and accuracy of the transvaginal three-dimensional hysterosalpingo-contrast sonography(3D HyCoSy) on the fallopian tube patency. Methods 3D HyCoSy was performed in twenty-two cases with infertility. Image quality of 3D HyCoSy was evaluated. The estimate of the fallopian tube patency in 3D HyCoSy were compared with those of hysterosalpinography(HSG) in one week. Results The mean score of image quality of 3D HyCoSy in twenty-two cases was 2. 8 + 0. 5. The accuracy of the unobstructed and obstructed fallopian tube were 88.9% (24/27) and 94.1% (16/17) respectively, and the total accuracy was 90. 9% (40/44) , which was equal to the results of HSG (P = 0. 000,k = 0. 812). No adverse reactions of SonoVue occurred in the cases. Conclusions Transvaginal 3D HyCoSy which is a new imaging technique can safely and effectively display the morphological character of fallopian tube and assess the patency. Key words: Ultrasonography ; Microbubbles; Hysterosalpingography; Infertility