Contrast-tuned imaging and second-generation contrast agent SonoVue: a new ultrasound approach to evaluation of tubal patency.
OBJECTIVE
To determine whether transvaginal hysterosalpingo-contrast sonography (HyCoSy) with a new dedicated contrast-enhanced ultrasound technique, can contribute to accurate diagnosis of tubal occlusion.


METHODS
Prospective observational study (Canadian Task Force classification II-2).


METHODS
University hospital.


METHODS
Two-hundred twelve patients with primary or secondary infertility.


METHODS
All patients underwent transvaginal HyCoSy. If the tubes showed no evidence of patency after injection of air-saline solution, a solution with sulphur hexafluoride bubbles (SonoVue) was injected into the uterine cavity and tubes while contrast-tuned imaging (CnTI) was applied. Patients with tubal occlusion underwent laparoscopic chromoperturbation.


RESULTS
Of the 212 patients who underwent tubal insufflation with air-saline solution, 52 demonstrated tubal occlusion, bilateral in 21 patients and unilateral in 31 patients, for a total of 73 suspected occluded tubes. At the HyCoSy test with SonoVue and CnTI, only 47 tubes seemed to be occluded, and in the other 26 tubes, passage of SonoVue was observed. HyCoSy with Sono Vue demonstrated high concordance for tubal obstruction with the laparoscopic dye test (94%).


CONCLUSIONS
HyCoSy with SonoVue and CnTi is a low acoustic pressure technique in which bubbles are not immediately destroyed and can be detected for several minutes. This enables the signal sent to the equipment to be filtered from the echoes emanating from other tissues. Therefore, excluding the fundamental image, the bubbles are clearly observed, with no visualization of pelvic tissues and organs. This allows easier evaluation of tubal patency, provides a more accurate assessment of tubal occlusion, and enables better visualization of the tubal course.
Exacoustos
Caterina
C
Department of Obstetrics and Gynecology, Università degli Studi di Roma Tor Vergata, Rome, Italy. caterinaexacoustos@tiscali.it
Zupi
Errico
E
Szabolcs
Beata
B
Amoroso
Concetta
C
Di Giovanni
Alessandra
A
Romanini
Maria Elisabetta
ME
Arduini
Domenico
D
D000328:Adult; D003287:Contrast Media; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography; D055815:Young Adult
D003287:Contrast Media