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European Radiology

, Volume 29, Issue 2, pp 501–508 | Cite as

Magnetic resonance hysterosalpingography in diagnostic work-up of female infertility – comparison with conventional hysterosalpingography: a randomised study

  • Manuelle VolondatEmail author
  • Eric Fontas
  • Jerome Delotte
  • Imene Fatfouta
  • Patrick Chevallier
  • Madleen Chassang
Urogenital
  • 242 Downloads

Abstract

Objective

To compare diagnostic accuracy of MR-hysterosalpingography (MR-HSG) and conventional hysterosalpingography (X-HSG) in the evaluation of female infertility.

Methods

Forty women received prospectively both X-HSG, the gold standard technique, and MR-HSG on the same day but the order in which they were conducted was randomised. A 1.5 Tesla MRI was performed with classical sequences for pelvic analysis and an additional 3D T1-weighted sequence with intra-uterine injection of gadolinium. Two radiologists independently interpreted X-HSG and MR-HSG according to randomisation, blinded to the other results. They both then performed a second interpretation of MR-HSG blinded to the first reading with a minimum time delay of 1 week. Diagnostic performance of MR-HSG for analysis of tubal and intracavity abnormalities was evaluated by calculating sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).

Results

Twenty-six patients were included. Diagnostic performance of MR-HSG was: Se: 91.7% (95% CI 61.5–99.8); Sp: 92.9% (95% CI 66.1–99.8) ; PPV: 91.7% (95% CI 61.5–99.8); NPV: 92.9% (95% CI 66.1–99.8). Pain analysis showed a significant statistical difference between the two procedures: average VAS for X-HSG was 4.43 (95% CI 3.50–5.36) versus 3.46 (95% CI 2.62–4.31) for MR-HSG, p=0,01. Intra- and inter-rater agreements for detection of tubal or intracavity abnormalities were 0.92 (95% CI 0.78–1.00) and 0.76 (95% CI 0.52–1.00).

Conclusion

MR-HSG is a well-tolerated technique demonstrating high accuracy in investigating tubal patency and intra-uterine abnormalities for diagnostic work-up of female infertility.

Key Points

• MR-hysterosalpingography is an innovative technique.

• Hysterosalpingography can be used to investigate tubal patency and intracavity abnormalities.

• Hysterosalpingography is a potential ‘one-stop-shop’ imaging technique for a single comprehensive examination of female infertility.

Keywords

Female infertility Magnetic resonance imaging Hysterosalpingography Fallopian tubes Uterus 

Abbreviations

CI

Confidence interval

FOV

Field of view

hCG

Human chorionic gonadotropin

ICC

Intraclass correlation coefficient

K

Kappa coefficient

MRI

Magnetic resonance imaging

MR-HSG

Magnetic resonance hysterosalpingography

NPV

Negative predictive value

PACS

Picture archiving system

PPV

Positive predictive value

Se

Sensitivity

Sp

Specificity

SPIR

Spectral Presaturation with Inversion Recovery

T1W

T1-weighted

T2W

T2-weighted

TE

Echo time

TR

Repetition time

TSE

Turbo spin echo

VAS

Visual analogue scale

WHO

World Health Organization

X-HSG

Conventional hysterosalpingography

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr Madleen Chassang.

Conflict of interest

The authors of this article declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Dr Eric Fontas kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• randomised controlled trial

• performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Manuelle Volondat
    • 1
    Email author
  • Eric Fontas
    • 2
  • Jerome Delotte
    • 3
  • Imene Fatfouta
    • 3
  • Patrick Chevallier
    • 1
  • Madleen Chassang
    • 1
  1. 1.Department of RadiologyArchet University HospitalNiceFrance
  2. 2.Department for Clinical Research and InnovationUniversity Hospital of NiceNiceFrance
  3. 3.Department of Obstetrics, Gynecology, Reproduction and Fetal medicineArchet University HospitalNiceFrance

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