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Saline and Air Bubbles

History as Contrast for Ultrasound Tubal Evaluation

Using saline and air as a contrast for sonographic imaging of the fallopian tubes was found to be highly concordant to laparoscopic chromopertubation (LC) and fluoroscopic hysterosalpingography (Fluoro HSG) as evidenced by the studies below.

Sono HSG Compared to LC
Reference
Number
of Tubes
Sensitivity
( % )
Specificity
( % )
Concordance
( % )
Allahbadia
Fertility and Sterility. 1992;58(5):901-907.
134
Not reported
94
Heikkinen et al.
Fertility and Sterility. 1995;64(2):293-298.
61
82
86
85
Volpi et al.
Ultrasound Obstetrics Gynecology. 1996;7:43-48.
56
85
92
89
29
63
100
90
Inki et al.
Acta Obstetricia et Gynecologica Scandinavica. 1998;77:978-982.
53
90
83
89
29
86
77
79
30
75
91
87

As was stated by Spalding et al., not even LC is 100% reliable for testing tubal patency. According to the American Society for Reproductive Medicine (Optimal evaluation of the infertile female. Fertility and Sterility. 2006; 86(4).): "All available methods for evaluation of tubal factors have technical limitations that must be considered when any one technique yields abnormal results." Accurate diagnosis and effective treatment of tubal obstruction often requires more than one evaluation method.

Sono HSG Compared to Fluoro HSG
Reference
Number
of Tubes
Sensitivity
( % )
Specificity
( % )
Concordance
( % )
Allahbadia
Fertility and Sterility. 1992;58(5):901-907.
134
Not reported
88
142
Not reported
85
Spalding et al.
Ultrasound Obstetrics Gynecology. 1999;14:205-209.
31
50
97
94
67
80
94
90

These studies included numerous patients where Sono HSG detected patency and Fluoro HSG incorrectly determined blockage.


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