Causes of misdiagnosis in assessing tubal patency by transvaginal real-time three-dimensional hysterosalpingo-contrast sonography

Liang, Na; Li, Jinghua; Gao, Feng-Yun; Sun, Fenyong; Guo, Cuixia

doi:10.1590/1806-9282.65.8.1055

Cited by 8 publications

(21 citation statements)

References 17 publications

(7 reference statements)

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“…The investigator needed to have enough experience on TVS 4D HyCoSy to make a comprehensive analysis of the observed conditions and finally give a diagnosis. The operator factor was one of the main causes of misdiagnosis, 26 HyCoSy's obvious interobserver variability is nonnegligible, 14 and HyCoSy results are highly dependent on the operator’ skill, 36 particularly in the judgement of the “partially passible” condition. Almost all of the diagnostic features of “partially passible” were subjective descriptions and judgments, such as slim, tortuous, slight spillage at the fimbria end of the tube, and others, indicating a lack of quantitative or semi‐quantitative objective evaluation indicators 37 …”

Section: Discussionmentioning

confidence: 99%

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Clinical Significance of Increasing Pressure Curve's Slope When Injecting Ultrasound Contrast Agent During Evaluation of Fallopian Tubal Patency

Cai

2021

J of Ultrasound Medicine

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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.

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Section: Discussionmentioning

confidence: 99%

“…4D HyCoSy is accurate as it visualizes the entire volume of the tube to portray the contrast throughout the tube. The accuracy of 4D HyCoSy increases to 87.5%–97.7% 7,23,25–26 …”

Section: Introductionmentioning

confidence: 96%

Clinical Significance of Increasing Pressure Curve's Slope When Injecting Ultrasound Contrast Agent During Evaluation of Fallopian Tubal Patency

Cai

2021

J of Ultrasound Medicine

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“…However, some false-positive or inconclusive diagnoses can occur due to poor image quality or an inappropriate initial transverse plane on TVS-4D-HyCoSy [8,12], which can lead to a series of unnecessary interventions, such as laparoscopy. The appropriate initial plane is critical to the success of volume imaging.…”

Section: Introductionmentioning

confidence: 99%

“…However, it requires the region of interest to encompass the full course of the fallopian tube, not merely the fimbrial end. It has been reported that the position and morphology of the fallopian tube can influence the image quality and that different diagnostic methods should be applied to improve the diagnostic accuracy [8,12]. A few specific cases of the Fallopian tubal position have been reported [12,15].…”

Section: Introductionmentioning

confidence: 99%

Value of ovarian positional assessment on 4D hysterosalpingo-contrast sonography

Zheng

Chen

et al. 2022

Med Ultrason

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Aims: To investigate the positional relationship between the ovary and Fallopian tube and the relationship between the ovarian position and tubal morphology.Material and methods: A total of 195 patients with 338 fallopian tubes were enrolled in this retrospective study. The ovarian and tubal positions were defined relative to the uterus in all directions. Tubal morphology was classified as smooth or tortuous.Results: The distribution of the Fallopian tubes corresponded to the positions of the ipsilateral ovaries in the superoinferior direction (χ2 =197.653, p<0.001), mediolateral direction (χ2 =237.447, p <0.001) and anteroposterior direction (χ2 =109.746, p<0.001). Tubal morphology differed according to ovarian position in the superoinferior (χ2 =21.804, p<0.001), mediolateral directions (χ2 =4.679, p=0.031) but not in the anteroposterior direction (χ2 =0.793, p=0.373).Conclusions: Evaluating the ovarian position can provide preliminary information on the distribution and shapeof the Fallopian tube, helping the operator choose the appropriate initial plane and the necessary approaches for inspection.

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“…The medical definition of female infertility is that no contraceptive measures have been taken for more than one year, and the sexual life is normal without a successful pregnancy. Besides, it is mainly divided into primary infertility and secondary infertility [ 1 ]. There are many causes of female infertility, mainly including ovulation disorders, fallopian tube factors, and abnormal endometrial receptivity.…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging Feature Analysis and Evaluation of Tubal Patency under Convolutional Neural Network in the Diagnosis of Infertility

Liu

Ren

2021

Contrast Media & Molecular Imaging

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To explore the diagnostic value of MRI image features based on convolutional neural network for tubal unobstructed infertility, 30 infertile female patients were first selected as the research objects, who admitted to the hospital from May 2018 to January 2020. They all underwent routine MRI examinations and CNN-based MR-hysteron-salpingography (HSG) examinations, in order to discuss the diagnostic accuracy of the two examinations. In the research, it was necessary to observe the patients’ imaging results, calculate the diagnosis rate of the two examination results, and analyze the application effect of the CNN algorithm, thereby selecting the best reconstruction method. In this study, the analysis was conducted on the basis of no statistical difference in the baseline data of the included patients. The results of undersampling reconstruction at 2-fold, 4-fold, and 6-fold showed that CNN for data consistency layer (CNN_DC) had a better effect, and its peak signal-to-noise ratio (PSNR) was lower sharply than that of the other two reconstruction methods, while the normalized mean square error (NMSE) and structural similarity index measure (SSIM) were higher markedly than the values of the other two reconstruction methods. The diagnostic rate of routine MRI examination of the fallopian tube and other parts of the uterus was lower than or equal to that of MR-HSG examination by CNN. Routine MRI examinations of fallopian tube imaging artifacts were large, and the definition was reduced, which increased the difficulty of identification. However, MR-HSG examination by CNN indicated that the imaging artifacts were low, the clarity was high, and the influence of noise was small, which was conducive to clinical diagnosis and identification. For endometriosis, the accuracy of MR-HSG was 33.33% and the accuracy of MRI was 46.67%. CNN MR-HSG inspection method was significantly better than the conventional MRI inspection method P < 0.05 . Therefore, the results of this study revealed that MR-HSG examination by CNN had a clear imaging effect and obvious inhibition effect on background signals and rapid image generation without the need for reconstruction with the same spatial resolution, which improved the imaging quality and could provide a reference value for clinical diagnosis and subsequent related studies.

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Causes of misdiagnosis in assessing tubal patency by transvaginal real-time three-dimensional hysterosalpingo-contrast sonography

Cited by 8 publications

References 17 publications

Clinical Significance of Increasing Pressure Curve's Slope When Injecting Ultrasound Contrast Agent During Evaluation of Fallopian Tubal Patency

Clinical Significance of Increasing Pressure Curve's Slope When Injecting Ultrasound Contrast Agent During Evaluation of Fallopian Tubal Patency

Value of ovarian positional assessment on 4D hysterosalpingo-contrast sonography

Magnetic Resonance Imaging Feature Analysis and Evaluation of Tubal Patency under Convolutional Neural Network in the Diagnosis of Infertility

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