Valentina Cipolla, Presenter: Nothing to Disclose

Renato Argiro, Abstract Co-Author: Nothing to Disclose

Daniele Guerrieri MD, Abstract Co-Author: Nothing to Disclose

Domiziana Santucci, Abstract Co-Author: Nothing to Disclose

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

To confirm the improvement over the years of 3 Tesla magnetic resonance imaging hysterosalpingography (3T MR-HSG), as single comprehensive imaging approach to female infertility.

Two hundred and sixteen infertile women underwent 3T MR-HSG. After standard imaging of the pelvis, dynamic study was performed by acquiring T1-weighted 3D time-resolved imaging of contrast kinetics (TRICKS) sequences during manual injection of 4-5 ml of contrast solution consisting of gadolinium (0.5 ml) and normal saline (20 ml). This procedure was carried out 1, 2 or 3 times. Two radiologists independently analyzed images. Regarding tubal patency, possible diagnoses were: fast tubal patency; delayed tubal patency; asymmetrical tubal patency; loss of regular tubo-ovarian relationship; bilateral tubal occlusion.

3T MR-HSG was successfully completed in 97.5%, failure rate was 2.5%. Analysis of morphological sequences revealed extratubal-extracavitary abnormalities in 44.9%, while uterine cavity abnormalities were found in 25% of patients. Overall extratubal abnormalities were detected in 69.9% of cases. Dynamic sequences showed intramural and ampullary portions of the tube in 85.7% while diagnosis of tubal patency was made indirectly in the remaining 14.3%. Bilateral tubal patency was found in 62%, among which 34.5% presented fast and symmetrical bilateral tubal patency and regular tubo-ovarian relationship. Unilateral tubal patency was found in 25%, among which 14.6% presented fast unilateral tubal patency with regular tubo-ovarian relationship. Bilateral tubal occlusion was detected in 9.4%. Average examination time was 18 min.  

Over the years 3T MR-HSG showed a sensitive improvement in diagnostic accuracy for extratubal abnormalities and tubal visualization, allowing the clear depiction of intratubal spillage of contrast media, despite the very small amount injected. Execution time and failure rate were also reduced. After a three years experience, we could affirm that 3T MR-HSG is a simple, fast, safe and well tolerated examination. 3T MR-HSG represents a comprehensive “one-stop-shop” examination and should be employed as first level imaging tecnique in female infertility investigation.

3T MR-HSG represents a fast and accurate, comprehensive imaging examination for female infertility.

Cipolla, V, Argiro, R, Guerrieri, D, Santucci, D, De Felice, C, Improvement of 3T MR-HSG as "One-stop-Shop" Imaging Approach to Female Infertility: Our Experience Over the Years.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13028387.html