Objective
To explore the association between Fallopian tubal patency and the slope of the increasing pressure curve for ultrasound contrast agent.
Materials and Methods
A total of 136 patients underwent transvaginal 4‐dimensional hysterosalpingo‐contrast sonography (TVS 4D HyCoSy) between August 2015 and January 2016. We divided the patients into 3 groups according to different Fallopian tubal patency status: 71 patients (48.97%) in bilateral tubal patency group, 45 (31.03%) in unilateral tubal patency group, and 20 in bilateral tubal nonpatent group. The ultrasound contrast agent was injected and the pressure curve was recorded automatically in real time using a liquid‐injecting machine that traces it as a pressure curve. The slopes of the different groups are compared through independent sample t test.
Results
The slopes of the 3 groups were 1.242 ± 0.572, 1.472 ± 0.638, and 2.068 ± 1.236 kPa/s. A correlation was observed between the slope of the increasing pressure curve and tubal patency (R = 0.287, P < .05). The slopes differed significantly between the bilateral tubal patency group and bilateral tubal nonpatent group (P = .001) and between the unilateral tubal patency group and bilateral tubal nonpatent group (P = .012). However, the difference between the bilateral tubal patency and unilateral tubal patency groups was not significant (P = .266).
Conclusion
The increase of the injecting pressure curve's slope for contrast agent during 4D HyCoSy is associated with the nonpatent degree of the tube. This condition can be used as an objective index of tubal patency and can be a reference in diagnosis and treatment.
Inter-observer agreement between the two non-expert examiners was good for the ESHRE/ESGE (k = 0.74, 95% CI 0.55-0.92) and very good for ASRM and CUME classification systems (k = 0.96, 95% CI 0.88-1.00; and k = 0.91, 95% CI 0.79-1.00), respectively. Agreement between the ESHRE/ESGE and ASRM was moderate for both examiners. Agreement between ESHRE/ESGE and CUME classifications was moderate for examiner 1 and good for examiner 2. Agreement between ASRM and CUME was good for both examiners. Conclusions: The three classifications have good (ESHRE/ESGE) or very good (ASRM, CUME) inter-observer agreement. Agreement between ASRM and CUME was higher than that for ESHRE-ESGE and ASRM and ESHRE-ESGE and CUME. OC15.04 4D ultrasound guidance improves embryo transfer success rates: a randomised controlled trial
most localized renal neoplasms. Controversy continues with respect to efficacy and benefit of PN in management of complex renal mass (CRM). We determined impact of surgical modality on post-operative functional outcomes in CRM.METHODS: We performed retrospective analysis utilizing the ROSULA registry. CRM was defined as RENAL nephrometry score 10-12. The cohort was divided into PN and radical nephrectomy (RN) for descriptive analyses. Primary outcome was development of de novo post-operative estimated glomerular filtration rate (eGFR) <45 mL/min/ 1.73m 2 . Secondary outcomes were development of de novo eGFR <60 and delta eGFR (DeGFR) between diagnosis and last follow-up. Cox proportional hazards multivariable analysis (MVA) was used to elucidate predictors for de novo eGFR <45 and <60. Linear regression was utilized to analyze DeGFR. Kaplan Meier Analysis (KMA) was performed to analyze freedom from de novo eGFR <60 and <45.RESULTS: 970 patients were analyzed (RN[429, PN[541; median follow up 24.0 months). RN patients had lower BMI (27.2 vs. 28.9, p<0.001) but larger median tumor size (8.4 vs. 5.1 cm, p<0.001) and RENAL score (11.0 vs. 10.0, p<0.001). Post-operative complication rate was higher for PN (24.0% vs. 14.2%, p<0.001), but there was no significant difference in major complications (Clavien III-IV) (PN 5.2% vs. RN 2.6%, p[0.702). Median DeGFR at last follow up was greater in RN (-22.4 vs. -11.4, p<0.001). MVA demonstrated increasing age (HR 1.07, p<0.001) and RN (HR 1.6, p[0.019) to be independently associated with increased risk de novo eGFR <45. Increasing age (HR 1.05, p<0.001), larger tumor size (HR 1.05, p[0.048), RN (HR 2.51, p<0.001), and higher BMI (HR 1.04, p[0.001) were independent risk factors for de novo eGFR <60. RN (B [ -8.28, p<0.001) was associated with greater DeGFR. KMA revealed significantly worse 5-year freedom from de novo eGFR <45 (79% vs. 65%, p<0.001) and de novo eGFR <60 (71% vs. 33%, p<0.001) for RN.CONCLUSIONS: PN may provide functional benefit in select patients with CRM without significant increase in major complications, and may be considered as a preferred option when feasible and clinically indicated.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.