Valentina Cipolla, Presenter: Nothing to Disclose

Giuseppe Borgoni, Abstract Co-Author: Nothing to Disclose

Alessandra Marini MD, Abstract Co-Author: Nothing to Disclose

Carlo De Felice MD, Abstract Co-Author: Nothing to Disclose

Mario Marini MD, Abstract Co-Author: Nothing to Disclose

Andrea Stagnitti MD, Abstract Co-Author: Nothing to Disclose

Emanuela Pasqualitto, Abstract Co-Author: Nothing to Disclose

Luca Bertana, Abstract Co-Author: Nothing to Disclose

The aim of this study was to evaluate if Magnetic Resonance - Hysterosalpingography (MR-HSG) using 3 Tesla MRI system can be used to ascertain tubal patency and to determine its role in the diagnostic workup of infertile women and to compare to HSG (Hysterosalpingography).

32 consecutive infertile women were recruited among subjects who had already undergone HSG with findings of bilateral tubal patency and regular contour of the uterine cavity. The absence of uterine pregnancy within 12 months of HSG provided the indication for MR-HSG. MRI examination was performed on a 3-T MR unit: approximately 10 mL of a 1:10 mixture of gadolinium to normal sterile saline (0.9%) was injected transcervically into the uterine cavity through a 7-French catheter, while acquiring seven consecutive fat-saturated 3D gradient-echo sequences. A set of dynamic subtracted images and 3D maximum intensity projections was reconstructed and reviewed by two experienced readers. MR-HSG diagnoses were compared to final HSG diagnoses. Patient comfort were assessed by a specific questionnaire.  

We successfully evaluated tubal patency in 84.3% women using 3T MR HSG. Failure rate was 15.7%. Bilateral fallopian tube patency was confirmed by MR-HSG in 62.5%. Tubal occlusion was found in 21.8% cases. Particularly MR-HSG showed monolateral tubal occlusion in 15.7%, bilateral tubal occlusion in 6.1%. Furthermore 34.4% of women were found to have abnormalities on MRI that were not suspected on conventional HSG. The average time for the study was 35-40 min. MR examination was generally well tolerated.  

This study provided a proof of the feasibility of dynamic 3T MR-HSG showing that tubal patency can be effectively assessed using this technique. Furthermore 3T-HSG provides a complete evaluation of other causes of infertility and was predominantly well tolerated. However it is characterized by a longer examination time and potential higher failure rates than HSG and its use will certainly be limited by practical constraints.

MR HSG might become a feasible alternative to conventional HSG in the diagnostic work-up of infertile women in a “ one-stop-shop ”.

Cipolla, V, Borgoni, G, Marini, A, De Felice, C, Marini, M, Stagnitti, A, Pasqualitto, E, Bertana, L, Magnetic Resonance-Hysterosalpingography at 3 Tesla Machine: Preliminary Evidence.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11015434.html