Patricia M. Carrascosa MD, Presenter: Research Consultant, General Electric Company

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

Carlos Capunay 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 typical findings of V-HSG by MDCT in daily practice and the differential diagnosis with other pathologies.

We evaluated the V-HSG studies of 10000 patients (mean age 35.4 ± 3.5 years) derived from our institution. Studies were performed using 64,128 and 256 multislice CT scanners. Scanning parameters were: On 64-row CT: slice thickness of 9 mm and a reconstruction interval of 0.45 mm, 120 kV and 100-250 mAs, with an average duration of each scan of 3.6 seconds. On 128 and 256-slice CT: slice thickness of 6 mm and a reconstruction interval of 3 mm, 80 kV and 100-150 mAs, with an average duration of each scan of 1.3 seconds. For visualization of the internal genital organs 10-20 ml of a dilution of low-osmolality iodinated contrast was instilled into the uterine cavity. Images were analyzed using multiplanar reconstructions, 3D and virtual endoscopy.The duration of the CT scan, the radiation exposure and the degree of discomfort of the patients were documented.  

Using 64-row CT scanners, the mean radiation dose was 0.9 mSv. Using 128 to 256-slice CT scanners the mean radiation dose was 0.3 msv. In the cervical region were identified parietal irregularities (26%), thickening of folds (10%), polyps (8%), diverticula (6%), stricture (6%) and adhesions (1%). At the level of the uterine cavity showed polyps (35%), submucous fibroids (9%) and adhesions (4%). In addition changes were observed in the wall of the uterus: fibroids (15%), malformations (3,6%), adenomyosis (6%) and cesarean section (11%). 4% of the uterine tubes are not visualized completely. Unilateral hydrosalpinx was visualized (8%) and bilateral (1,5%). Patients reported no or mild discomfort in 85% of the cases.  

The Virtual-HSG allowed a proper assessment of the internal genital organs, providing useful diagnostic information on infertility and other gynecological disorders. The technique is painless, well tolerated by patients with low doses of radiation. These advantages place this modality as a valid alternative algorithm study in patients with infertility  

CT Virtual Hysteroscopy provides a complete, minimally invasive evaluation of the female reproductive system. Low radiation doses are very important.

Carrascosa, P, Vallejos, J, Capunay, C, Baronio, M, Carrascosa, J, Virtual Hysterosalpingography in 10000 Cases.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13026047.html