Patricia M. Carrascosa MD, Abstract Co-Author: Research Consultant, General Electric Company

Carlos Capunay MD, Abstract Co-Author: Nothing to Disclose

Javier Vallejos MD, MBA, Presenter: Nothing to Disclose

Mariano Baronio, Abstract Co-Author: Nothing to Disclose

Infertility has been assigned mainly to fallopian tube pathology. The objective of this presentation is to show the prevalence of tubal pathology in patients with diagnosis of infertility who has performed a CT virtual hysterosalpingography (CT-VHSG).

We evaluated 10465 consecutive patients (age 35+/-4.7 years old) with diagnosis of infertility by CT-VHSG. Exams were carried out with a 64-,128- and 256-slice CT scanners using the following technical parameters: slice thickness, 0.6 mm; reconstruction interval, 0.325mm; 100-150 mAs and 80-120 kV. After cleaning the vagina with povidone-iodine solution, a speculum was placed and a plastic cannula was inserted in the external cervical ostium. A volume of 10-20 ml of a hyposmolar dilution at 70% was instilled to the uterine cavity with a power injector. Once acquired images were reprocessed using 2D and 3D reconstructions. The fallopian tubes were classified as: 1) Normal, 2) Pathologic. The pathologic tubes were also subdivided in those with ampullar dilatation, hydrosalpinx, intratubal sinechiae, intratubal polyps, tubal pathologic displacement, negative peritoneal contrast spillage (negative Cotte test).

The scan time was 2.1+/-1.3 sec. The complete study duration was 27+/-8 minutes. The mean radiation dose was 0.7 mSv. From 10465 patients, a total of 20905 fallopian tubes were available for evaluation. There were 17548 (84%) normal and 3357 (16%) pathologic fallopian tubes. Pathologic findings included: occlusion, negative Cotte test, ampullar dilatation. hidrosalpingx, intratubal sinechiae, intratubal polyps, abnormal position, blocked peritoneal contrast spillage.  

In patients with infertility referred to a CT-VHSG, only the 16% of the fallopian tubes were pathologic. For that reason, the importance of an integral diagnostic procedure that accurately evaluates the tubes but also the uterus (cervix and body) is mandatory to discard other pathologies. In the daily practice, there’s a general overestimation of fallopian tube pathology.

CT Virtual Hysterosalpingography provides a complete, minimally invasive evaluation of the female reproductive system, with an accurate evaluation of the fallopian tubes, using bidimensional, tridimensional and endoscopic views.

Carrascosa, P, Capunay, C, Vallejos, J, Baronio, M, Prevalence of Fallopian Tube Pathology in Infertile Women. CT Virtual Hysterosalpingography Findings.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018575.html