Advertisement

Virtual Hysterosalpingography: A New Diagnostic Technique for the Study of the Female Reproductive Tract

Chapter

Abstract

Imaging studies in infertile patients have become an important aspect in the evaluation of the female reproductive tract. Although conventional hysterosalpingography (HSG) remains the study most commonly requested, new technologies have been introduced which overcome the limitations associated with HSG. Over the past decade the development of multidetector computed tomography (MDCT) technology, with a capacity for exceptionally high spatial and temporal resolution, has revolutionized the examination of the heart, colon (Carrascosa et al., Acta Gastroenterol Latinoam 33(3):145–149, 2003), and airways. Virtual hysterosalpingography is an emerging application that combines the capabilities of multidetector CT with the established technique of hysterosalpingography, allowing for a more comprehensive evaluation of the female reproductive system.

The technique itself is simple, short, and relatively painless. Our experience with over 7,000 patients showed that the images generated for analysis through multiplanar reconstruction, maximum intensity projection (MIP), volume rendering, and virtual endoscopy demonstrated a clear visualization of the uterine cavity (Carrascosa et al., Abdom Imaging 33(4):381–387, 2008), fallopian tubes, and extrauterine structures, allowing the diagnosis of polyps, myomas, uterine anomalies, and tubal pathology (Carrascosa et al., Eur J Radiol 67(3):531–535, 2008) with a high degree of accuracy. The simplicity of the study together with the lack of discomfort is certainly one of its greatest advantages. The use of ionizing radiation could be considered a relative disadvantage; however, the exposure is lower when compared to conventional HSG at our center.

Our main objective in writing this chapter is to share our experience with this new technology, to describe optimal protocols for improved image acquisition, to fully discuss and illustrate post-procedure processing and image reconstruction, and finally, to show images of the various diagnoses one is able to make by using virtual HSG. We are confident that this evolving technology will eventually replace conventional HSG for the evaluation of the female reproductive tract given its many diagnostic advantages.

Keywords

Fallopian Tube Maximal Intensity Projection Female Reproductive Tract Soft Tissue Density Endoscopic View 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Carrascosa P, Capunay C, Sangster D, Carrascosa J. Virtual colonoscopy: experience in 500 patients. Acta Gastroenterol Latinoam. 2003;33(3):145–9.PubMedGoogle Scholar
  2. 2.
    Carrascosa P, Capunay C, Baronio M, Lopez EM, Borghi M, Sueldo C, Papier S. Virtual hysteroscopy by multidetector computed tomography. Abdom Imaging. 2008;33(4):381–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Carrascosa P, Baronio M, Capunay C, Lopez E, Borghi M, Sueldo C, Papier S. Multidetector CT virtual hysterosalpingography in the investigation of the uterus and fallopian tubes. Eur J Radiol. 2008;67(3):531–35.PubMedCrossRefGoogle Scholar
  4. 4.
    Carrascosa P, Baronio M, Capunay C, Lopez EM, Sueldo C, Papier S. Clinical use of 64-row multislice CT hysterosalpingography in the evaluation of female factor infertility. Fertil Steril. 2008;90(5):1953–58.PubMedCrossRefGoogle Scholar
  5. 5.
    Carrascosa P, Capunay C, Vallejos J, Baronio M, Lopez EM, Borghi M, Sueldo C, Papier S. 64 Row multidetector CT virtual HSG. Abdom Imaging. 2009;34(1):121–33.Google Scholar
  6. 6.
    Carrascosa P, Capunay C, Vallejos J, Baronio M. Gadolinium vs iodine virtual HSG: an alternative for patients allergic to iodine 64 row multidetector CT virtual HSG. Fertil Steril. 2008;90:S157.Google Scholar
  7. 7.
    Carrascosa P, Capunay C, Vallejos J, Lopez EM, Carrascosa J. Virtual HSG: a new multidetector CT technique for evaluating the female reproductive system. Radiographics. 2010;30(3):643–61.PubMedCrossRefGoogle Scholar
  8. 8.
    Celik O, Karkas H, Hascalik S, Tagluk M. Virtual hysterosalpingography and hysteroscopy: assessment of uterine cavity and fallopian tubes using 64-detector CT data sets. Fertil Steril. 2010;93(7):2383–84.PubMedCrossRefGoogle Scholar
  9. 9.
    Carrascosa P, Capunay C, Vallejos J, Baronio M, Carrascosa J. Virtual hysterosalpingography: experience with over 1000 consecutive patients. Abdom Imaging. 2011;36(1):1–14.PubMedCrossRefGoogle Scholar
  10. 10.
    Carrascosa P, Sueldo C, Capunay C, Baronio M, Papier S. Virtual HSG in the diagnosis of bicornuate vs septate uterus. Fertil Steril. 2011;96(5):1190–92.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Maipu DiagnosticsBuenos AiresArgentina
  2. 2.Department of Obstetrics and Gynecology (REI Division)University of California San Francisco-FresnoClovisUSA

Personalised recommendations