The Influencing Factors of Venous Intravasation During Transvaginal Four-dimensional Hysterosalpingo-contrast Sonography With SonoVue

Abstract

Transvaginal 4-D hysterosalpingo-contrast sonography with SonoVue (TV 4-D HyCoSy) is the preferred imaging method for evaluating tubal patency. However, venous intravasation in 4-D HyCoSy may affect the diagnosis of tubal patency. The objective of this study was to analyze influencing factors of venous intravasation during TV 4-D HyCoSy. This study included 643 infertile patients who underwent TV 4-D HyCoSy. We analyzed the relationship between the incidence of venous intravasation and patients' basic clinical data, endometrial thickness, inspection timing (clean day of menstruation) and tubal patency. A total of 169 (26.28%) patients exhibited intravasation during TV 4-D HyCoSy. The following are risk factors for venous intravation: secondary infertility, type C + C, type B + C and type B + B in bilateral fallopian tubal patency grouping; endometrial thickness 5.45 mm; and taking TV 4-D HyCoSy after menstruation 6 d. Infertility duration, intrauterine lesions, a history of pelvic inflammatory disease and a history of pelvic surgery were uncorrelated with venous intravasation. To reduce the incidence of venous intravasation, TV 4-D HyCoSy should be performed 7À10 d after menstruation or when endometrial thickness is thicker than 5.45 mm.

Green urine sign after laparoscopic chromopertubation as an effect of severe contrast intravasation: a report of three cases

“…11 Previous reports have also described the intravasation phenomenon with the HSG procedure during the performance of hysterosalpingo-foam sonography (HyFoSy) and transvaginal four-dimensional hysterosalpingo-contrast sonography with SonoVue (TV 4D HyCoSy). [12][13][14] Ludwin et al 12 presented a case report of mild intravasation during HyFoSy using air/saline as a contrast agent. The risk factor for intravasation specified in the cited publication was unilateral occlusion of the fallopian tube.…”

“…14 Notably, the estimated frequency of intravasation during HyCoSy ranges from 26.3% to 27.9%. 13,14 This is almost four times higher than the frequency during HSG. [6][7][8] The following question thus arises: What is the difference in the frequency of occurrence of intravasation in otherwise similar procedures?…”

“…Shi et al. 14 identified risk factors for intravasation during 4D HyCoSy TV. The most important were conditions associated with secondary infertility, tubal patency, and endometrial thickness of <5.45 mm.…”

Spontaneous conception outcome in infertile women after four-dimensional hysterosalpingo-contrast-sonography

“…A Voluson E8 Expert (GE Healthcare, Zipf, Austria) With RIC5-9-D volume probe (5-9 MHz) was used. Equipment settings for 4 dimensional contrast sonography were as follows: volume box angle at 179°, volume angle at 120°, quality at low, direction at up/down, render mode at gradient light and threshold, Low at < 20, adjusted according to the image [14,17]. The contrast agent was prepared by adding 5 ml of 0.9% sterile saline solution to 59 mg of SF6 Sonovue freeze-dried powder (Bracco International BV, Amsterdam, the Netherlands), then 2.5 ml SonoVue solution was aspirated and diluted it into a 15 ml suspension with the 0.9% of saline solution.…”

“…The contrast agent was passed through the catheter into the uterine cavity, following which the flow of the contrast agent in the fallopian tube and the overflow at the tubal fimbriae were observed. The dynamic enhanced volume images were saved and analyzed after the injection of the contrast medium [2,11,14].…”