title: Two-dimensional HyCoSy with contrast tuned imaging technology and a second-generation contrast media for the assessment of tubal patency in an infertility program.
abstract: OBJECTIVE
  To compare the efficiency of hysterosalpingo-contrast-sonography performed with air and saline (Hydro-HyCoSy) with HyCoSy performed with contrast media (SonoVue) and contrast-tuned imaging technology (CnTI-SonoVue-HyCoSy) considering hysterosalpingography (HSG) and laparoscopy (LPS) as reference tests and to evaluate the learning curve of this procedure.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Reproductive unit of a university hospital.
  
  
  METHODS
  Forty-two infertile female patients.
  
  
  METHODS
  HyCoSy were performed with a 2.4-mm intrauterine catheter. Patients underwent HSG or LPS as controls.
  
  
  METHODS
  Mean age, sensitivity, specificity, positive and negative predictive value, kappa value, and diagnostic accuracy were evaluated for statistical analysis.
  
  
  RESULTS
  Sensitivity, specificity, and positive and negative predictive values of Hydro-HyCoSy were 91%, 71%, 55%, and 95%, respectively, while for CnTI-SonoVue-HyCoSy they were 87%, 84%, 69%, and 94%. The diagnostic accuracy of Hydro-HyCoSy and of CnTI-SonoVue-HyCoSy were 77% and 85%, with a Cohen's kappa of 0.52 and 0.66, respectively. CnTI-SonoVue-HyCoSy does not require a learning curve period.
  
  
  CONCLUSIONS
  CnTI-SonoVue-HyCoSy is more accurate than Hydro-HyCoSy for the assessment of fallopian tubes. The very high normal predictive value of Hydro-HyCoSy suggests that this procedure could be performed as a screening examination, whereas CnTI-SonoVue-HyCoSy could be used as a second-step technique.
authors.affiliation: Department of Obstetrics and Gynecology Clinical Sciences Institute L. Sacco, University of Milan, Milan, Italy. Electronic address: chiara.lanzani@unimi.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lanzani
authors.affiliation: Department of Obstetrics and Gynecology Clinical Sciences Institute L. Sacco, University of Milan, Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Savasi
authors.affiliation: Department of Obstetrics and Gynecology Clinical Sciences Institute L. Sacco, University of Milan, Milan, Italy.
authors.forename: Francesco P G
authors.initials: FPG
authors.lastname: Leone
authors.affiliation: Department of Obstetrics and Gynecology Clinical Sciences Institute L. Sacco, University of Milan, Milan, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Ratti
authors.affiliation: Department of Obstetrics and Gynecology Clinical Sciences Institute L. Sacco, University of Milan, Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ferrazzi
mesh_terms: D000328:Adult; D003287:Contrast Media; D005186:Fallopian Tube Patency Tests / Q000379:methods*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000000981:diagnostic imaging*; D010535:Laparoscopy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media