Contrast ultrasound: a simple-to-use phase-shifting medium offers saline infusion sonography-like images.
OBJECTIVE
To test the ability of a novel phase-shifting medium (PSM) to provide sustained distension of the uterine cavity and produce saline infusion sonography (SIS)-like images in a simplified contrast ultrasound procedure.


METHODS
Prospective pilot feasibility trial of a new diagnostic procedure, contrast ultrasound.


METHODS
Clinical reproductive endocrine and infertility unit of regional teaching hospital.


METHODS
Twenty-six asymptomatic infertile women (group I) and 27 women presenting with dysfunctional uterine bleeding (DUB) who were scheduled for exploratory surgery (group II).


METHODS
All women who were temporarily on oral contraceptive first had a regular pelvic ultrasound followed by the intrauterine instillation of up to 3 mL PSM, using a regular insemination catheter, after which all instruments were removed and a regular ultrasound was performed again.


RESULTS
In all 53 women, intrauterine instillation of 1-3 mL PSM resulted in a 3-7 mm uterine distension, sufficient to produce SIS-like images of the uterine cavity that lasted 7-10 min. Contrast ultrasound revealed an endometrial polyp in 3 asymptomatic women of group I. In group II. 12 of 14 women (86%) whose vaginal ultrasound were positive or dubious had positive findings with contrast ultrasound; 9 of 12 patients whose vaginal ultrasounds were negative also had positive contrast ultrasound findings. All the positive and negative findings of contrast ultrasound made in group II were confirmed anatomically (sensitivity and specificity of 100%), whereas the correlation for standard vaginal ultrasound was markedly lower at 57.1% and 85.7%, respectively. Most patients (46 of 53) reported no discomfort during or after the procedure, and 7 women described the procedure as mildly uncomfortable.


CONCLUSIONS
Contrast ultrasound, a novel simple diagnostic procedure conducted after intrauterine instillation of 1-3 mL PSM using a simple plastic catheter, delivered SIS-quality images in asymptomatic (group I) and symptomatic (group II) patients while retaining the simplicity of standard ultrasound. We therefore foresee broad application of contrast ultrasound for sensitive and specific assessment for uterine pathologies in the physician's office.
de Ziegler
Dominique
D
Reproductive Endocrinology and Infertility, Obstetrics and Gynecology, Nyon Medical Center, Nyon, Switzerland. ddeziegler@orange.fr
D003470:Culture Media; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007247:Infertility, Female / Q000000981:diagnostic imaging*; D009092:Mucous Membrane / Q000000981:diagnostic imaging; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D012965:Sodium Chloride / Q000494:pharmacology*; D014463:Ultrasonography / Q000379:methods*; D014599:Uterus / Q000000981:diagnostic imaging*; D014621:Vagina / Q000000981:diagnostic imaging
D003470:Culture Media; D012965:Sodium Chloride