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Hysterosalpingography in endometriosis: performance and interpretation

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Abstract

Endometriosis is often seen and sometimes initially diagnosed on hysterosalpingography (HSG), an imaging exam routinely performed on patients with infertility. Here we discuss the role of HSG in the evaluation of patients with infertility with a focus on patients with endometriosis. The HSG technique, including patient preparation as well as potential risks and complications, is detailed. Imaging findings in patients with endometriosis are illustrated and a template for exam reporting is presented. Common imaging pitfalls are described with examples.

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Acknowledgements

Aoife Kilcoyne would like to acknowledge the contribution of the MacErlaine Research Scholarship from the Academic Radiology Research Trust, St. Vincents Radiology Group, Dublin, Ireland, and the Higher Degree Bursary, from the Faculty of Radiologists, RCSI, Ireland. Aileen O’Shea would like to acknowledge the contribution of the MGH-MacErlaine Research Scholarship from the Faculty of Radiologists, RCSI, Ireland, and Massachusetts General Hospital. The authors would like to thank Susanne Loomis for her assistance in preparing the figures.

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Correspondence to Aoife Kilcoyne.

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Aoife Kilcoyne and Susanna I Lee are authors for UpToDate, Wolters Kluwer, on Hysterosalpingography.

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Kilcoyne, A., O’Shea, A., Gervais, D.A. et al. Hysterosalpingography in endometriosis: performance and interpretation. Abdom Radiol (2020). https://doi.org/10.1007/s00261-019-02373-w

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Keywords

  • Female pelvic imaging
  • Gynecology
  • Infertility
  • Mullerian anomalies
  • Adenomyosis
  • Fallopian tube
  • Pelvic adhesions
  • Peritubal adhesions
  • Tubal occlusion