Patricia M. Carrascosa MD, Presenter: Research support, Koninklijke Philips Electronics NV

Carlos Capunay MD, Abstract Co-Author: 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 illustrate the spectrum of findings and the differential diagnosis with other pathologies.

We retrospectively evaluated 4500 CT-VHSG studies performed in our institution for the evaluation of infertility. The mean age of the studied population was 37.2 +/- 3.9 years old. CT-VHSG exams were performed using a 64-row CT scanner (Brilliance 64, Philips Medical Systems). Scans parameters were: 0.9 mm slice thickness, 0.45 mm reconstruction interval, 120 kV and 50-200 mAs. A total volume of 20 ml iodine contrast dilution (3ml of iodine contrast and 17ml of saline solution) were administered into the uterine cavity using a semi-rigid plastic cannula. CT images were evaluated on a workstation using multiple post-processing techniques. The scanning time, the radiation exposure and the grade of discomfort were also documented.

In the cervical region CT-VHSG demonstrated: wall irregularities (23%), folds thickening (10%), cervical polyps (9%), diverticulaes (6%), cervical stenosis (8%), cervical synechiaes (1%). CT-VHSG findings in the uterus were divided according to the location. Uterine cavity findings were: polyps (40%), submucous myomas (9%), synechiaes (11%). Uterine wall abnormalities included: intramural and subserous myomas (9%), uterine malformations (8%), adenomyosis (5%) y C-section scar (3%). Fallopian tubes findings included: unilateral hydrosalpinx (8%) and bilateral hydrosalpinx (2%), tubal obstruction (4%). The 7% of the fallopian tubes were partially visualized in the CT-VHSG studies. The scan time was 3.2 +/- 1.1 sec. The effective radiation dose was 0.93 +/- 0.08 mSv. The 86% of the patients referred only mild or no disconfort.

CT-VHSG allowed an adequate and accurate evaluation of the female internal genital organs, providing a complete diagnostic information in patients with infertility. This is minimally invasive low radiation dose technique, well tolerated for the vast majority of the patients. This modality appears as a valid alternative diagnostic test in the algorithm of patients with infertility.

Virtual hysterosalpingography is an innovative imaging test that combines the benefits of high temporal and spatial resolutions of the MDCT technology with the traditional X-ray HSG technique.

Carrascosa, P, Capunay, C, Vallejos, J, Baronio, M, Carrascosa, J, Virtual Hysterosalpingography: Experience in 4500 Cases.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11016984.html