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. 2019 Jun 3:2019:9408141.
doi: 10.1155/2019/9408141. eCollection 2019.

Combined Real-Time Three-Dimensional Hysterosalpingo-Contrast Sonography with B Mode Hysterosalpingo-Contrast Sonography in the Evaluation of Fallopian Tube Patency in Patients Undergoing Infertility Investigations

Sumin Chen  1   2 , Xiya Du  1 , Qingzi Chen  1 , Shaoqi Chen  1
Affiliations

Combined Real-Time Three-Dimensional Hysterosalpingo-Contrast Sonography with B Mode Hysterosalpingo-Contrast Sonography in the Evaluation of Fallopian Tube Patency in Patients Undergoing Infertility Investigations

Sumin Chen et al. Biomed Res Int. .

Abstract

Objective: This prospective study aimed to investigate the use of real-time three-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy), using contrast agent SonoVue, with B mode hysterosalpingo-contrast sonography (B mode-HyCoSy), to evaluate tubal patency and the wall of the Fallopian tubes in infertility patients.

Method: In total, we recruited 739 women with fertility requirements from the First Affiliated Hospital of Shantou Medical College between January 2017 and July 2018. All cases received 4D-HyCoSy using contrast agent SonoVue, immediately followed by the B mode-HyCoSy. Of these patients, 145 showed pathological findings in the Fallopian tubes during HyCoSy; 34 of these (62 Fallopian tubes) were verified by laparoscopy and the dye test against routine reference standards. Sonographic findings, along with laparoscopic findings and dye test results, were used to compare the two techniques using the Cohen kappa coefficient. We also investigated the duration of examination and pain score.

Results: Compared with laparoscopy and the dye test, the tubal occlusion diagnostic accordance rates for 4D-HyCoSy were 88.7% (32+23)/62, with a kappa coefficient of 0.769 and a 76.9% agreement rate. Distal occlusion diagnostic accordance rates for 4D-HyCoSy were 100% (8/8) with a k coefficient of 1.000 and a 100% agreement rate.

Conclusions: The use of 4D-HyCoSy, with B mode-HyCoSy, for the diagnosis of tubal patency is safe, feasible, noninvasive, and highly accurate. B mode-HyCoSy allowed us to observe tubal walls in an intuitive manner.

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Figures

Figure 1
Figure 1
Tubal patency diagnosed by 4D-HyCoSy: (a) bilateral patent oviducts; (b) bilateral obstructed oviduct.
Figure 2
Figure 2
Tubal patency diagnosed by B mode-HyCoSy: (a) right patent oviduct; left patent but not smooth; (b) right patent oviduct; left obstructed oviduct.
Figure 3
Figure 3
The whole right Fallopian tube appeared to be patent when viewed by 4D-HyCoSy; however, the right distal end of the tube was distended with hydrosalpinx (a). A subsequent examination with B mode-HyCoSy confirmed the existence of an obstruction in the Fallopian tube fimbria (b).
Figure 4
Figure 4
Right oviduct misdiagnosed as proximal partial obstruction in 4D-HyCoSy (a). A subsequent examination with B mode- HyCoSy confirmed the misdiagnosis (b). The whole right Fallopian tube (small arrow); the contrast medium spayed from the Fallopian tube fimbria (large arrow).
See this image and copyright information in PMC

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