Jody Michelle Riherd, Abstract Co-Author: Nothing to Disclose

Jennifer E. Ochsner MD, Abstract Co-Author: Nothing to Disclose

Elizabeth Alina Sadowski MD, Presenter: Nothing to Disclose

Thomas Charles Winter MD, Abstract Co-Author: Spouse, CEO, Micrablate LLC Speakers Bureau, General Electric Company

Mark Alan Kliewer MD, Abstract Co-Author: Nothing to Disclose

Elizabeth Pritts MD, Abstract Co-Author: Nothing to Disclose

David Olive MD, Abstract Co-Author: Nothing to Disclose

Thomas Martin Grist MD, Abstract Co-Author: Research grant, General Electric Company Speakers Bureau, General Electric Company Research grant, Schering AG (Berlex Inc) Speakers Bureau, Schering AG (Berlex Inc) Consultant, Schering AG (Berlex Inc)

et al, Abstract Co-Author: Nothing to Disclose

To develop a protocol for MR hysterosalpingography (MR-HSG) and to compare it to conventional hysterosalpingography (cHSG) in the evaluation of tubal patency in women.

15 women, ages 27-45, with the diagnosis of infertility were recruited after undergoing a cHSG. 8 subjects had free bilateral intraperitoneal spill, 5 subjects had a single occluded fallopian tube, and 2 subjects had bilateral tubal occlusion on cHSG. Anatomical MR images were performed on a 1.5T system using a pelvic coil. After anatomical images were obtained, 20-40 cc of 1:100 dilute gadodiamide saline solution was infused into the uterus through a 5F hystero-salpingography catheter during a dynamic time-resolved T1-weighted sequence (3D TRICKS) acquisition. Temporal resolution of 1.8 seconds per volume was achieved using a slice thickness of 4-5mm, a matrix of 256x128, a FOV of 26-28, and 16-18 slices/volume. The acquisition time during injection was approximately 1 minute. A final T1-weighted, fat suppressed 3D-SPGR series was obtained to evaluate for intraperitoneal contrast in the pelvis. The cHSG and MR-HSG studies were read independently by a single blinded reader.

There was 1 failed exam due to patient motion. All of the 19 fallopian tubes with free peritoneal spill on cHSG also had free spill on MR-HSG. Of the 9 occluded tubes on cHSG, 5 demonstrated free peritoneal spill on MR-HSG. The remaining 4 occluded tubes on cHSG also showed occlusion on MR-HSG. In addition to tubal patency, MRI discovered 4 subjects with large leiomyomas and 3 subjects with arcuate uterine configurations, which were suggested on cHSG due to endometrial contour deformity.

This preliminary data indicates that 3D time-resolved MR-HSG may be a more sensitive study to conventional HSG in the evaluation of tubal patency in infertile women. MR-HSG depicted free peritoneal spill in more than half of the fallopian tubes considered occluded by conventional HSG.

MR-HSG may provide a comprehensive and definitive pelvic imaging examination in the evaluation of women with infertility, without the use of ionizing radiation.

Riherd, J, Ochsner, J, Sadowski, E, Winter, T, Kliewer, M, Pritts, E, Olive, D, Grist, T, et al, , MRI in the Evaluation of Tubal Patency in Women.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4433719.html