Multidetector computed tomography virtual hysterosalpingography in the investigation of the uterus and fallopian tubes

• Published in: European journal of radiology 2008-09, Vol.67 (3), p.531-535
• Main Authors: Carrascosa, Patricia, Baronio, Mariano, Capuñay, Carlos, López, Elba Martín, Vallejos, Javier, Borghi, Mario, Sueldo, Carlos, Papier, Sergio
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Female; Humans; Hysterosalpingography; Hysterosalpingography - methods; Infertility, Female - diagnostic imaging; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Multidetector computed tomography; Radiology; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed - methods; User-Computer Interface; Virtual hysterosalpingography; Virtual studies; Young Adult
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2007.08.004

Abstract Objective To compare the efficacy of multidetector CT virtual hysterosalpingography (MDCT-VH) with conventional X-ray hysterosalpingography (HSG) in the evaluation of patients with diagnosis of infertility. Methods Sixty patients with diagnosis of infertility scheduled to perform a HSG, were evaluated with 16-row ( n = 50) and 64-row ( n = 10) MDCT-VH. In 35 patients the examination was performed without a tenaculum. The HSGs were carried out using standard technique. The HSG and MDCT-VH findings were compared. The duration for both examinations and patient discomfort were documented. The sensitivity and specificity of MDCT-VH for the detection of uterine pathology and tubal obstruction were calculated using the exact binomial method. Agreement between the two methods was assessed by the Cohen's kappa method ( k ). Results The mean duration for MDCT-VH (16 and 64-rows) was 5 ± 3 min, whereas for HSG was 28 ± 3. The MDCT-VH without a tenaculum was the procedure with less patient discomfort. Sensitivity, specificity and inter-method agreement for the detection of uterine pathology were 100%, 92% and k = 0.92 for 16-row MDCT-VH and 100%, 100% and k = 1 for 64-row MDCT-VH, respectively. Sensitivity and specificity for detection of tubal obstruction were 80% and 80% for 16-row MDCT-VH and 100% and 100% for 64-row MDCT-VH, respectively; inter-method agreement for the visualization of the tubes was k = 0.54 for 16-row MDCT-VH and k = 1 for 64-row MDCT-VH. Conclusion This study demonstrated the feasibility of evaluating the female reproductive system by MDCT-VH. 64-Row MDCT-VH could be an alternative diagnostic technique in the infertility workup algorithm. A larger study is in progress to validate these encouraging results.