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Based on the literature, the following ultrasound techniques have been utilized to successfully perform a Sono HSG fallopian tube evaluation with saline and air as contrast.
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Pre-Contrast Delivery
- Landmark the position of each ovary relative to the uterus in the transverse view.
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Learning to scan the tube can be achieved by trying to
locate the proximal part of the salpinx in every patient
and then detecting the ovary by following the broad
ligament laterally.
Volpi, Ultrasound Obstetrics Gynecology. 1996;7:43-48.
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- Locate endometrial stripe and uterine cornual interface in the transverse view.
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By rotating the probe through 90°, a trans-section of the uterus was taken to localize the uterine-tubal junction. The broadest magnification was used to visualize the salpinges.
Heikkinen, Fertility and Sterility. 1995;64(2):293-298.
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During Contrast Delivery
- Orient probe to assess saline-air contrast flow in one tube.
Flow may be seen bilaterally.
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Uterus should not be too distant from probe. The tube was followed as distally as possible by slowly tracing the probe over it and simultaneously distending the uterus to straighten the salpinges.
Heikkinen, Fertility and Sterility. 1995;64(2):293-298.
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- Locate flow in Zone 1 and hold to observe.
- Assess each zone by slowly and methodically scanning to observe tubal flow.
- Evaluate contralateral tube.
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The process of scanning and searching for salpinges during injection should be methodical and constant. Normally we started at the uterine cornu in a plane that also visualized the interstitial part of the tube, and then scanned laterally. The flow of air bubbles near the ovaries was observed. Salpinges were examined separately.
Exacoustos, The Journal of the American Association of Gynecologic Laparoscopists. 2003;10(3):367-371.
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