Role of hysterosalpingoscintigraphy in the workup of infertility.
OBJECTIVE
To assess the role of hysterosalpingoscintigraphy (HSSG) in the evaluation of fallopian tube patency and function and compare the results with hysterosalpingography (HSG) and laparoscopy (LS).


METHODS
Cross-sectional study.


METHODS
The study was conducted at Multan Institute of Nuclear Medicine and Radiotherapy (MINAR), Multan from August 2004 to February 2005.


METHODS
HSSG was performed after instillation of 4mCi (148 MBq) 99mTechnetium-macroaggregated albumin (99mTc-MAA) in posterior vaginal fornix in 65 patients. Serial static images were acquired in supine position at 1 hour, 2 hours, 3 hours and, if needed, at 24 hours. The results were compared to the findings on LS and HSG.


RESULTS
Out of 65 patients, 37 (56.9%) patients had bilateral blocked tubes, 17 (26.1%) patients had bilateral patent tubes, 6 (9.2%) patients had blocked left tube and 5 (7.1%) patients had blocked right tube. The calculated sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV) and accuracy for HSSG were 90%, 83%, 90% and 90% respectively. The agreement between HSSG and LS was found in 32 out of 35 patients and agreement between HSG and HSSG was found in 24 out of 30 patients.


CONCLUSIONS
This simple procedure can delineate tubal physiology; in selected cases it can replace HSG and in others augment the information gathered by HSG. HSSG should be part of the infertility workup algorithm.
Akhtar
Kalsoom
K
Department of Nuclear Medicine, Bahawalpur Institute of Nuclear Medicine and Oncology (BINO), Bahawalpur.
Sabih
Durr-E-
DE
Laghari
Naeem Ahmed
NA
Mateen
Abdul
A
Sabih
Zahida
Z
Haq
Anwar-Ul-
AU
Anees
Muhammad
M
Alam
Iftikhar
I
Kausar
Farzana
F
D005186:Fallopian Tube Patency Tests; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000175:diagnosis / Q000000981:diagnostic imaging*; D010535:Laparoscopy; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin