Three-Dimensional HyCoSy With Perfluoropropane-Albumin Microspheres as Contrast Agents and Normal Saline Injections Into the Pelvic Cavity for Morphological Assessment of the Fallopian Tube in Infertile Women

Hong, Qingqing; Cai, Renfei; Chen, Qiuju; Zhang, Shaozhen; Ai, Ai; Fu, Yonglun; Kuang, Yanping

doi:10.7863/ultra.16.03041

Cited by 11 publications

(12 citation statements)

References 24 publications

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“…It had been reported that ovarian mobility is a sonographic “soft marker” in evaluating deep infiltrating endometriosis and extensive pelvic adhesions, both of which are associated with subfertility [ 27 , 28 ]. Furthermore, some research has indicated that injective resistance and contrast agent venous intravasation are associated with diagnostic results [ 8 , 21 – 30 ]; however, which of these is most relevant to pregnancy has not been reported. Our univariate analysis showed that patency of the tubes, mobility of the ovaries, and injective resistance are related to pregnancy after HyCoSy exam and that contrast agent venous intravasation and the identity of the sonographer are not related to pregnancy after HyCoSy exam, whereas multivariate analysis showed that patent fallopian tubes and no injective resistance were the related factors.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Influence on Spontaneous Pregnancy of Hysterosalpingo-Contrast Sonography

Gao

Peng

Yan

et al. 2018

BioMed Research International

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Objective Our objective was to explore whether the pregnancy rate (PR) was higher than usual after hysterosalpingo-contrast sonography (HyCoSy). Methods We conducted a prospective observational study of 1,008 infertility patients, all of whom were examined by HyCoSy. The expected time for spontaneous pregnancy was at least 180 days after the HyCoSy exams. There were three types of HyCoSy results: type I, defined as both fallopian tubes patent; type II, defined as one fallopian tube patent with obstruction in the other; and type III, defined as both fallopian tubes obstructed. During the HyCoSy examinations, we recorded the mobility of the ovaries, injective resistance, and contrast agent venous intravasation. Before the examinations, we recorded each patient's medical history, including maternal age, infertility type, median duration of menstrual cycle, dysmenorrhea, and parity number. Results The PR was 19.44% within 180 days after HyCoSy and it was significantly higher in the first 30 days (6.35%) (P <.01). The PR of type I was highest, with a rate of 32.01%, followed by the PR of type II (25.51%) and type III (15.04%) (P <.01). Univariate analysis showed that younger age, patency of both fallopian tubes, good ovarian mobility, and absence of injective resistance were positively related to the initiation of pregnancy (P <.01). Infertility type, median duration of menstrual cycle, dysmenorrhea, parity number, contrast agent venous intravasation, and identity of the sonographer were unrelated to pregnancy (P >.05). However, multivariate analysis showed that patency of both fallopian tubes and the absence of injective resistance were independently associated with pregnancy. Conclusion Some infertility patients conceived successfully and naturally not long after HyCoSy, most often in the first month after the examination. Multivariate analysis showed that patency of both fallopian tubes and the absence of injective resistance were independently factors associated with the ability to conceive after HyCoSy examination.

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Section: Discussionmentioning

confidence: 99%

Assessment of the Influence on Spontaneous Pregnancy of Hysterosalpingo-Contrast Sonography

Gao

Peng

Yan

et al. 2018

BioMed Research International

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“…Our study showed that when the amount of normal saline injection reached 40–120 mL (average 80 mL), it could achieve an ideal display effect. The amount was still significantly less than that needed by transvaginal posterior fornix puncture 16 . In this study, when SIPS via intrauterine route combined with another contrast mode of HyCosy called 2D‐FS, the combination's diagnostic efficacy for assessing tubal patency was similar to that of D3D‐HS, but on the other hand, its ability of locating the fimbrial parts was much better than the latter.…”

Section: Discussionmentioning

confidence: 68%

“…(3) Patient's acceptance is limited. Moreover, a large amount of normal saline (1000–1500 mL) 16 needs to be injected to expose the areas of interest (especially when the fimbrial parts' position are opposite to the direction of gravity), which will add to the patient's discomfort. We chose the intrauterine route to inject normal saline through the natural cavity which can reduce the shortcomings mentioned above.…”

Section: Discussionmentioning

confidence: 99%

The Performance of Transvaginal Two‐Dimensional Fundamental Sonosalpingography Combined with Saline Infusion Pelvic Sonosalpingography for Assessing Fimbrial Part's Morphology and Function of the Fallopian Tubes

Peng

et al. 2021

J of Ultrasound Medicine

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Objectives The purpose of this study was to evaluate the diagnostic efficacy of transvaginal two‐dimensional fundamental sonosalpingography (2D‐FS) combined with saline infusion pelvic sonosalpingography (SIPS) for assessing fimbrial part's morphology and function of the fallopian tubes. Methods One hundred and sixty‐nine cases underwent 2D‐FS combined with SIPS. Among them, 18 cases received laparoscopy and dye test (LDT) within 3 months after the examination and the results were regarded as reference standard. Results Excluding proximal or middle segment obstructed tubes, the remaining fimbrial parts' display rate by using 2D‐FS combined with SIPS was 75.1%. According to the ultrasonic appearance, the fimbrial parts were classified into 4 types: normal, abnormal, suspected abnormal, and unclassifiable. Normal fimbrial parts accounted for 73.8% when the tubes were patent; abnormal fimbrial parts accounted for 74.1% when the tubes were partial obstructed; all became abnormal when the tubes were distal complete obstructed. The fimbrial parts which had been classified by 2D‐FS combined with SIPS were compared with LDT further. This combination's accuracy (ACC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and Youden's index (YI) were 86.4, 87.5, 85.7, 77.8, 92.3, and 0.73%, respectively. The result of consistency analysis showed the combination was essentially consistent with LDT result (Kappa = 0.713). Conclusion 2D‐FS combined with SIPS can be a preferred method for assessment of the fimbrial part's morphology and function, with its advantages of non‐invasive, intuition, and accuracy. This combination could provide an objective imaging basis for choosing clinical treatment strategies and predicting prognosis.

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“…Pelvic adhesions can induce the oviduct to be lifted, or cause excessive distortion and a complex image of the oviduct. 12 The oviduct is pulled by the lateral adhesion to change the original distributions, the outflow of contrast agent from the oviduct fimbria can flow to the periphery of the contralateral ovary, and adhesion can make the distal oviduct to go beyond the scope of scanning, making it difficult to distinguish whether the distal oviduct is unobstructed or obstructed. In a two-dimensional ultrasound examination, the topographical relationship of the ovary and uterus can roughly predict the distribution of the oviduct.…”

Section: Discussionmentioning

confidence: 99%

Causes of misdiagnosis in assessing tubal patency by transvaginal real-time three-dimensional hysterosalpingo-contrast sonography

Liang

Gao

et al. 2019

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE This study aims to investigate the causes of misdiagnosis in assessing tubal patency by transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy), in order to improve the diagnostic efficiency of TVS RT-3D-HyCoSy. METHODS A total of 162 oviducts of 83 infertility patients were examined by TVS RT-3D-HyCoSy. These results were compared with the gold standard for laparoscopic dye studies, and the misdiagnosed cases were analyzed. RESULTS TVS RT-3D-HyCoSy revealed that 68 oviducts were unobstructed and 94 obstructed. The results for the 144 oviducts were in line with the gold standard, while those for 18 oviducts were not. The accuracy rate of the TVS RT-3D-HyCoSy was 88.9%, and the misdiagnosis rate was 11.1%. The main causes of misdiagnosis included contrast medium countercurrent and diffusion, oviduct spasm, abnormal shape or position of the oviduct, pelvic adhesion, and poor imaging operation. CONCLUSION TVS RT-3D-HyCoSy can well-evaluate tubal patency, and understand and improve the cause of misdiagnosis. Furthermore, the diagnostic efficiency of TVS RT-3D-HyCoSy can still be further improved.

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Three-Dimensional HyCoSy With Perfluoropropane-Albumin Microspheres as Contrast Agents and Normal Saline Injections Into the Pelvic Cavity for Morphological Assessment of the Fallopian Tube in Infertile Women

Abstract: Combination of 3D HyCoSy with normal saline injected into the pelvic cavity may be a feasible and safe procedure to assess tubal patency and adhesions of the fimbrial parts.

Cited by 11 publications

References 24 publications

Assessment of the Influence on Spontaneous Pregnancy of Hysterosalpingo-Contrast Sonography

Assessment of the Influence on Spontaneous Pregnancy of Hysterosalpingo-Contrast Sonography

The Performance of Transvaginal Two‐Dimensional Fundamental Sonosalpingography Combined with Saline Infusion Pelvic Sonosalpingography for Assessing Fimbrial Part's Morphology and Function of the Fallopian Tubes

Causes of misdiagnosis in assessing tubal patency by transvaginal real-time three-dimensional hysterosalpingo-contrast sonography

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