The assessment of endometrial pathology and tubal patency: a comparison between the use of ultrasonography and X-ray hysterosalpingography for the investigation of infertility patients
| Autor: | Jane Thorburn, Christina Bergh, Seth Granberg, Tom Bourne, M Asztely, Annika Strandell |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Gynecology
Infertility medicine.medical_specialty Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Concordance Obstetrics and Gynecology General Medicine medicine.disease Contrast medium medicine.anatomical_structure Reproductive Medicine Predictive value of tests Medicine Radiology Nuclear Medicine and imaging Hysterosalpingography Prospective cohort study business Laparoscopy Fallopian tube |
| Zdroj: | Ultrasound in Obstetrics and Gynecology. 14:200-204 |
| ISSN: | 0960-7692 |
| Popis: | Objectives The aim of the present study was to examine the role of hysterosalpingocontrast sonography (HyCoSy) as a screening test for endometrial and tubal pathology at the start of the infertility investigation protocol. Methods HyCoSy was compared with X-ray hysterosalpingography (HSG) for the assessment of the endometrial cavity and Fallopian tube patency. A total of 103 women with a history of at least 1 year’s infertility were included. Each woman underwent both HyCoSy and HSG on the same day. Laparoscopy was performed in 43 cases. For HyCoSy examinations, saline was used for evaluation of the endometrial cavity and Echovist “ contrast medium to assess Fallopian tube patency. Results The concordance between HyCoSy and HSG for the presence of endometrial cavity pathology was 90%, but for tubal patency the concordance was lower (72%). HyCoSy classed more examinations of tubal patency as uncertain. HSG more frequently classified tubes as occluded. In the subset of patients in whom all three techniques were used, HSG and HyCoSy demonstrated a high concordance with laparoscopy (83% and 80%, respectively). The prevalence of occluded tubes according to laparoscopy as the reference standard was 13%. The two methods had a high negative predictive value for tubal disease (HSG, 94%; HyCoSy, 88%), and the positive predictive values were 47% and 75%, respectively. The detection rate for occluded tubes was 73% and 27%, and specificity 87% and 90%, respectively. Conclusions Our data demonstrate that HyCoSy obtains similar information about the status of the endometrial cavity and Fallopian tube patency to that of HSG. It is possible that in some cases HyCoSy may replace HSG in order to select women with patent tubes who may be suitable for further infertility treatment without more invasive investigation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text