[Hystero-salpingo-contrast-sonography with 3-d-ultrasound -- a pilot study].
Hystero-salpingo-contrast sonography (HyCoSy) is a sensitive method of assessing tubal patency but cannot completely substitute diagnostic laparoscopy with blue dye and hysteroscopy. Three-dimensional sonography has new imaging facilities which could lead to a reduction of invasive diagnostic procedures.


OBJECTIVE
The aim of this pilot study was to analyse the feasibility of HyCoSy by 3D- and 3D-Doppler-sonography.


METHODS
In a prospective setting conventional (2D) HyCoSy was performed in 21 patients with an ultrasound device designed for 3D-ultrasound. After the completion of the 2D procedure, 3D-ultrasound was carried out. In five patients an additional 3D-Doppler-HyCoSy was performed. The generated 3D-volumina were then examined. Laparoscopy with blue dye was performed immediately after the ultrasound examination.


RESULTS
A total of 42 Fallopian tubes was assessed. On 2D-ultrasound, visibility of the tubes was excellent in 28 and limited in seven tubes. Of the seven tubes not visible on 2D-ultrasound, four were not patent on laparoscopy. On 3D-ultrasound, visibility of the tubes was excellent in 15 and limited in twelve tubes. 15 tubes were not visible on 3D-ultrasound. 3D-Doppler-HyCoSy revealed excellent assessment in eight of ten tubes, even in one of those with limited visibility on 2D- and 3D-HyCoSy. In 19 patients the assessment of the uterine cavity was excellent by 2D- and 3D-HyCoSy, whereas it was limited in two patients.


CONCLUSIONS
It is possible to visualise the full length of the tubes in a very detailed way from the uterine cavity to the fimbrial end in some patients, but the diagnostic power of HyCoSy is not improved by adding 3D-imaging. The accuracy of 3D-ultrasound seemed to be improved by 3D-Doppler-ultrasound.
Watermann
D
D
Universitäts-Frauenklinik, Hugstetter Strasse 55, 79106 Freiburg. watermann@frk.ukl.uni-freiburg.de
Denschlag
D
D
Hanjalic-Beck
A
A
Keck
C
C
Karck
U
U
Prömpeler
H
H
D005187:Fallopian Tubes / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography
Hystero-Salpingo-Kontrastsonographie mit 3D-Ultraschall: eine Pilotstudie.