Clinical value of four-dimensional hysterosalpingo-contrast sonography assisted by intrauterine pressure measurement for tubal patency evaluation.
Valor clínico de la histerosalpingo-sonografía 4D por contraste, asistida por medición de la presión intrauterina, para evaluar la permeabilidad tubárica.
Abstract
We aimed to explore the clinical value of four-dimensional hysterosalpingo-contrast sonography (4D- HyCoSy) assisted by intrauterine pressure measurement for evaluating tubal patency. One hundred and thirty-two patients diagnosed with tubal factor infertility from February 2018 to February 2021 were selected as subjects. With hysterosalpingography diagnosis results as the gold standard, 4D-HyCoSy was conducted for all patients, and the status of the fallopian tubes was classified into patency, occlusion, and partial occlusion. Based on the function of fallopian tubes, 4D-HyCoSy diagnosis results revealed that fallopian tubes showed bilateral patency, incomplete patency (including bilateral partial occlusion, unilateral patency, and unilateral partial occlusion, unilateral patency and unilateral occlusion), unilateral partial occlusion and unilateral occlusion, and bilateral occlusion. The cutoff value of peak intra-uterine pressure was determined using the receiver operating characteristic curve (ROC), specificity, and the area under the ROC curve (AUC) between 4D-HyCoSy alone and 4D-HyCoSy assisted by intrauterine pressure measurements. There were significant differences in the peak intrauterine pressure among patients with bilateral patency, incomplete patency, unilateral partial occlusion, and unilateral and bilateral occlusions (p<0.05). The corresponding cutoff values of peak intrauterine pressure were 24.42, 36.34, and 47.68 kPa; AUC values were 0.812, 0.836, and 0.827, respectively. The FSM model showed that the AUC of 4D-HyCoSy alone, assisted by peak intrauterine pressure was 0.85, with a higher sensitivity (88.13%) than that of 4D- HyCoSy (p<0.05). 4D-HyCoSy, assisted by intrauterine pressure measurement, has an excellent value for evaluating tubal patency.
Downloads
References
Ruan SM, Zheng Q, Wang Z, Hu HT, Chen LD, Guo HL, Xie XY, Lu MD, Li W, Wang W. Comparison of real-time two-dimensional and three-dimensional contrasten-hanced ultrasound to quantify flow in an in vitro model: a feasibility study. Med Sci Monit 2019; 25: 10029-10035. https://doi.org/10.12659/MSM.919160.
Carson SA, Kallen AN. Diagnosis and management of infertility: a review. JAMA 2021; 326(1): 65-76. https://doi.org/10.1001/jama.2021.4788 .
Ludwin I, Ludwin A, Nastri CO, Coelho Neto MA, Kottner J, Martins WP. Interrater reliability of air/saline HyCoSy, HyFoSy and HyFoSy combined with power doppler for screening tubal patency. Ultraschall Med 2019; 40(1): 47-54. https://doi.org/10.1055/s-0043-120111.
Chen F, Quan J, Huang P, You X. Hysterosalpingo-contrast sonography with four-dimensional technique for screening fallopian tubal patency: let’s make an exploration. J Minim Invasive Gynecol 2017; 24(3): 407-414. https://doi.org/10.1016/j. jmig.2016.12.011.
Gu P, Yang X, Zhao X, Xu D. The value of transvaginal 4-dimensional hysterosalpingo-contrast sonography in predicting the necessity of assisted reproductive technology for women with tubal factor infertility. Quant Imaging Med Surg 2021; 11(8): 3698-3714. https://doi.org/10.21037/qims-20-1193.
Aggarwal D. Can HyCoSy replace laparos copy and hysteroscopy as a method to assess tubal patency and uterine cavity lesions. IOSR-JDMS 2019; 18(5): 80-83. https://doi.org/10.9790/0853-1805098083.
Ojha K, Goel T, Vinayagam D. Evaluation of Tubal Patency (HyCoSy, Doppler). In Ultrasound Imaging in Reproductive Medicine 2019 (pp. 239-248). Springer, Cham.
Gao YB, Yan JH, Yang YD, Sun J, Dong JY, Cui GH. Diagnostic value of transvaginal four‑dimensional hysterosalpingo‑contrast sonography combined with recanalization in patients with tubal infertility. Niger J Clin Pract 2019; 22(1): 46-50.
Shi J, Li S, Wu H, He Y, Yi W, Xu J, Liu H, Guan Y. The influencing factors of venous intravasation during transvaginal four-dimensional hysterosalpingo-contrast sonography with SonoVue. Ultrasound Med Biol 2019; 45(9): 2273-2280. https://doi.org/10.1016/j.ultrasmedbio.2019.05.003.
Exalto N, Emanuel MH. Clinical aspects of HyFoSy as tubal patency test insubfertility workup. Biomed Res Int 2019; 2019: 4827376. https://doi. org/10.1155/2019/4827376.
Wallyn J, Anton N, Mertz D, Begin-Colin S, Perton F, Serra CA, Franconi F, Lemaire L, Chiper M, Libouban H, Messaddeq N, Anton H, Vandamme TF. Magnetite and iodine-containing nanoemulsion as a dual modal contrast agent for X-ray/magnetic resonance imaging. ACS Appl Mater Interfaces 2019; 11(1): 403-416. https:// doi.org/10.1021/acsami.8b19517.
Zhang J, Zhang X, Bian J, Wang C. Comparation of magnetic resonance hysterosal pingography and hysterosalpingosonography for the assessment of fallopian tubal occlusion of female infertility: A protocol for systematic review and meta-analysis. Medicine 2022; 101(3): e28532. https://doi.org/10.1097/MD.0000000000028532.
Gad MS, Dawood RM, Antar MS, Ali SE. Role of hysteroscopy and laparoscopy in evaluation of unexplained infertility. Menoufia Med J 2019; 32(4): 1401-1405. https://doi.org/10.4103/mmj.mmj_387_18.
Dishuck CF, Perchik JD, Porter KK, Gunn DD. Advanced imaging in female infertility. Curr Urol Rep 2019; 20: 77. https://doi. org/10.1007/s11934-019-0942-0.
Lo Monte G, Capobianco G, Piva I, Caserta D, Dessole S, Marci R. Hysterosalpingo contrast sonography (HyCoSy): let’s make the point! Arch Gynecol Obstet 2015; 291(1): 19-30. https://doi.org/10.1007/s00404-014-3465-4.