Risk Factors of Contrast Agent Intravasation With Sulfur Hexafluoride Microbubble During Hysterosalpingo‐Contrast Sonography

Abstract

Objectives To analyze the risk factors of sulfur hexafluoride microbubble contrast agent intravasation during hysterosalpingo‐contrast sonography (HyCoSy), and to explore a simple prediction model by the obvious clinical history. Methods This was a retrospective study included 299 infertility women who had undergone HyCoSy examination from July 1, 2018 to June 31, 2019. The factors were recorded, including age, endometrial thickness, balloon length, infertility type, history of intrauterine surgery, history of pelvic surgery, and tubal patency. The method of multivariate logistic regression analysis was adopted to analyze the risk factors affecting the contrast agent intravasation, and the receiver operating characteristic curves were plotted to test their efficacy. Results Secondary infertility, a history of intrauterine surgery, thin endometrial thickness, and tubal obstruction were all risk factors of the occurrence of intravasation (P < .05). And the area under the receiver operating characteristic curves of the multifactor‐combined prediction model of the intravasation was significantly larger than that of single‐factor. Conclusions Sonographers and gynecologists should be familiar with the risk factors of intravasation and select the appropriate timing of HyCoSy toward reducing the occurrence of intravasation and other complications after thoroughly explaining and communicating with the patients.

Intravasation complicating hysterosalpingo‐foam sonography (HyFoSy) using ExEm® Foam

“…We also purport that rate of ExEm® Foam injection is a risk factor, with slower injection allowing time for spasm to subside but also reduces intravasation risk. Similar associations have been reported between thinner endometrium and intravasation at HyCoSy using SonoVue® (sulfur hexafluoride microbubbles) 19,21 …”

“…Endometrial thickness and days after menstruation have previously been suggested as risk factors for intravasation, variables which are related as endometrial thickness increases during the follicular phase of the menstrual cycle. 19,21 Further postulated risk factors include body mass index (BMI) and history of cervical large loop excision of the transformation zone (LLETZ) procedure.…”