Elba Beatriz Martin Lopez MD, Abstract Co-Author: Nothing to Disclose

Patricia M Carrascosa MD, Abstract Co-Author: Research support, Koninklijke Philips Electronics NV

Carlos Capunay MD, Presenter: Nothing to Disclose

Javier Vallejos MD, Abstract Co-Author: Nothing to Disclose

Mariano Baronio, Abstract Co-Author: Nothing to Disclose

Jorge Manuel Carrascosa MD, Abstract Co-Author: Nothing to Disclose

To show the role of CT Virtual Hysterosalpingography (VHSG) in the evaluation of Fallopian tubes, and its pathologic findings.

We retrospectively evaluated, 834 female patients, mean age 36.2 ± 3.3, derived to our institution to undergo a CT VHSG study. All the studies were performed in a 64row MDCT scanner (Brilliance 64, Philips Medical Systems) with slices of 0.9 mm thickness, 0.45 mm reconstruction interval, 120 kV and 150-250 mAs. The mean scan time was 4 seconds. Twenty millilitres of a diluted contrast (3ml of iodine contrast and 17ml of saline solution) were injected into the uterine cavity through a fine catheter. CT images were analyzed on a workstation using multiple post-processing techniques including multiplanar reconstructions, maximum intensity projections, volume rendering and virtual endoscopic images. CT images were evaluated for the visualization of the Fallopian tubes. The presence of intraluminal linear filling defects were considered as intratubal adhesions (synechiaes) and classified as focal or diffuse.  

Out of 1668 studied tubes, 1664 (99%) could be evaluated. There were only two patients with poor visualization and negative Cotte test. 108/834 patients (13%) presented tubal pathology. 1522/1668 studied fallopian tubes were normal. A negative Cotte test was seen in 8% of patients. A positive Cotte test was seen in 92%. In this group an association of tubal pathology with positive Cotte test was found in 40%. Most of them, 57%, showed distal dilatation, 23% showed abnormal morphology and 20% abnormal position. Hydrosalpinx (31% of patients), intratubal synechiaes (4%of patients) and occlusions (65%of patients) were generally associated to negative Cotte test.

This technique showed excellent results describing pathologic findings. A positive Cotte test was found in a considerable number of patients with tubal pathology.

CT Virtual Hysterosalpingography provides an adequate, less invasive evaluation of fallopian tubes with bidimensional, tridimensional and endoscopic views.

Martin Lopez, E, Carrascosa, P, Capunay, C, Vallejos, J, Baronio, M, Carrascosa, J, Tubal Patency: A Priority Point in the Infertility Workup Algorithm—Evaluation by Multidetector CT Virtual Hysterosalpingography.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8016091.html