Magnetic resonance hysterosalpingography in diagnostic work-up of female infertility – comparison with conventional hysterosalpingography: a randomised study
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To compare diagnostic accuracy of MR-hysterosalpingography (MR-HSG) and conventional hysterosalpingography (X-HSG) in the evaluation of female infertility.
Forty women received prospectively both X-HSG, the gold standard technique, and MR-HSG on the same day but the order in which they were conducted was randomised. A 1.5 Tesla MRI was performed with classical sequences for pelvic analysis and an additional 3D T1-weighted sequence with intra-uterine injection of gadolinium. Two radiologists independently interpreted X-HSG and MR-HSG according to randomisation, blinded to the other results. They both then performed a second interpretation of MR-HSG blinded to the first reading with a minimum time delay of 1 week. Diagnostic performance of MR-HSG for analysis of tubal and intracavity abnormalities was evaluated by calculating sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).
Twenty-six patients were included. Diagnostic performance of MR-HSG was: Se: 91.7% (95% CI 61.5–99.8); Sp: 92.9% (95% CI 66.1–99.8) ; PPV: 91.7% (95% CI 61.5–99.8); NPV: 92.9% (95% CI 66.1–99.8). Pain analysis showed a significant statistical difference between the two procedures: average VAS for X-HSG was 4.43 (95% CI 3.50–5.36) versus 3.46 (95% CI 2.62–4.31) for MR-HSG, p=0,01. Intra- and inter-rater agreements for detection of tubal or intracavity abnormalities were 0.92 (95% CI 0.78–1.00) and 0.76 (95% CI 0.52–1.00).
MR-HSG is a well-tolerated technique demonstrating high accuracy in investigating tubal patency and intra-uterine abnormalities for diagnostic work-up of female infertility.
• MR-hysterosalpingography is an innovative technique.
• Hysterosalpingography can be used to investigate tubal patency and intracavity abnormalities.
• Hysterosalpingography is a potential ‘one-stop-shop’ imaging technique for a single comprehensive examination of female infertility.
KeywordsFemale infertility Magnetic resonance imaging Hysterosalpingography Fallopian tubes Uterus
Field of view
Human chorionic gonadotropin
Intraclass correlation coefficient
Magnetic resonance imaging
Magnetic resonance hysterosalpingography
Negative predictive value
Picture archiving system
Positive predictive value
Spectral Presaturation with Inversion Recovery
Turbo spin echo
Visual analogue scale
World Health Organization
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Dr Madleen Chassang.
Conflict of interest
The authors of this article declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
Dr Eric Fontas kindly provided statistical advice for this manuscript.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• randomised controlled trial
• performed at one institution
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