Abstract
Several different techniques are available to image the female reproductive tract. These include performing a transvaginal ultrasonography (TVU), saline infusion sonography (SIS), hysterosalpingo-contrast sonography (HyCoSy), a hysterosalpingogram (HSG), or magnetic resonance imaging (MRI) procedure. Each method has its indications, technical considerations, and limitations. TVU is usually readily available, relatively inexpensive, and gives information about uterine size, shape, location of leiomyomas , and ovarian morphology. It gives limited information, however, on tubal and endometrial pathology. The SIS procedure is able to evaluate the endometrial cavity for polyps and/or an intracavitary leiomyoma. The SIS does not directly evaluate tubal patency. The HyCoSy procedure extends the SIS procedure by evaluating the fallopian tubes. The HyCoSy procedure may cause patient discomfort, can be limited in obese individuals, and may require additional supply items. The HSG procedure allows visualization of the entire fallopian tube, may increase post-procedure pregnancy rate, and is less limited by body habitus. The HSG is a more invasive procedure, exposes the patient to radiation, may be associated with a reaction to contrast material and is not available in all facilities. Magnetic resonance imaging (MRI) gives additional information on the location of uterine leiomyomas , adenomyosis, and congenital anomalies and is not limited by body habitus, but it is expensive and not available in all facilities. This chapter will seek to differentiate these different methods and highlight the timely and appropriate use of each reproductive imaging procedure.
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Abbreviations
- Adhesions:
-
Scar tissue either inside the uterus or in the pelvis caused by previous surgery, infection or tissue damage
- Artifact:
-
An object observed that occurs as a result of the preparation or unrelated to the topic investigated, that can give a false impression
- Endometrium:
-
Regenerative inner tissue layer of the uterus that undergoes monthly changes in response to circulating hormones
- HSG:
-
Hysterosalpingogram: Test to evaluate fallopian tube patency and the uterine cavity
- HyCoSy:
-
Hysterosalpingo-contrast sonography: Test to evaluate fallopian tube patency and the uterine cavity without radiation exposure
- Hydrosalpinx:
-
Fluid filled fallopian tube resulting from distal tubal occlusion
- Polyp:
-
Usually benign growth of the endometrium that contains a distinct blood supply
- Saline infusion sonography (SIS):
-
Ultrasound procedure whereby saline is infused into the uterus during ultrasound scanning to evaluate the uterine cavity
- Scintillation:
-
Images seen as a flash or sparkle through the fallopian tubes and/or around the ovaries during a HyCoSy procedure if tubal patency is present. Scintillations are a result of the air-fluid mixture moving through and exiting the distal fallopian tube
- Sonolucency:
-
An image during an ultrasound exam that appears black, since it allows passage of ultrasound waves without reflecting them back, also called an anechoic structure
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Krause, M.S., Nakajima, S.T. (2017). Reproductive Imaging. In: Falcone, T., Hurd, W. (eds) Clinical Reproductive Medicine and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-52210-4_5
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