MR-hysterosalpingography: technique and clinical application

Sergienya O.V., Вogatyreva E.V., Gorelova I.V., Grenkova Yu.M., Fokin V.A., Trufanov G.E.

Рurpose.To present the possibility of painless MR-hysterosalpingography (MR-HSG) in assessing the pass ability of fallopian tubes as alternative to traditional x-ray hysterosalpingography and laparoscopy. Materials and methods. 90 women were examined. The age of patients varied within 21-33 years. Prior to MR-hysterosalpingography, all patients were assessed for microflora and purity in analysis taken from the vagina and cervical canal; blood test for RW, HIV, analysis for sexually transmitted infections. Before the MRI, the gynecologist put a catheter in the pa-tient’s uterine cavity and fixed it in the area of the internal pharynx to prevent regurgitation of the contrast agent from the uterine cavity during its administration. Catheter with a soft balloon with a capacity of 2-3 cm3. Results. MRI with the infusion of a contrast agent into the uterine cavity made it pos-sible to assess the shape of the uterus, visualize the shape of the uterine horns, intramural, isthmic and ampullary parts of the fallopian tubes, the degree of penetration of contrast into the abdominal cavity and pass ability of the fallopian tubes. At the end of the study, postpro-cessing was performed using the technique of digital subtraction (subtraction of the pre-contrast images from the post-contrast images).); MIP-reconstructions of the fallopian tubes were performed to assess the degree of contrast agent spread into the uterine cavity, fallopian tubes and pelvic peritoneum. In 60 women (66.6%) in the behavior of MR-HSG fallopian tubes are passable, not expanded. In 14 women (15.5%) after MR-HSG, the fallopian tubes were not passable in the intramural sections on both sides, and there was no expansion of the fallopi-an tubes. In 7 women (7.7%), according to the results of MR-HSG, one of the fallopian tubes was not passable, not expanded. In 3 women (3.3%) the fallopian tubes are moderately de-formed due to scar changes, not dilated and not passable in isthmic calving on both sides. In 6 women (6.6%) there was an expanded and twisted one or two fallopian tubes with the pres-ence of a partial spreading of a contrast substance along the peritoneum to places remote from the ampoule; the flask-like dilated fallopian tubes remained, forming hydrosalpinx. Conclusion. MR-hysterosalpingography is a minimally invasive, radiation-safe MRI technique, the use of which allows to reliably determine the pass ability of the fallopian tubes. The revealed changes are highly correlated with the results of laparoscopy and x-ray hysterosalpingography.

Almazov National Medical Research Centre, Saint Petersburg, Russia


 

 

Keywords:magnetic resonance imaging, infertility, fallopian tubes, pass ability of the fallopian tubes.

 

Corresponding author:Sergienya O.V., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation:Sergienya O.V., Вogatyreva E.V., Gorelova I.V., Grenkova Yu.M., Fokin V.A., Trufanov G.E. MR-hysterosalpingography: technique and clinical application. REJR 2018; 8(4):165-171. DOI:10.21569/2222-7415-2018-8-4-165-171.

Received: 05.09.18 Accepted: 13.11.18