Skip to main content
Log in

Four-dimensional hysterosalpingo-contrast sonography with auxiliary hydrogen peroxide examination for the diagnosis of fallopian tube patency following interventional treatment of ovarian ectopic cysts

  • Images in Obstetrics and Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

The present study aimed to explore the practical value of using four-dimensional hysterosalpingo-contrast sonography with auxiliary hydrogen peroxide examination which is necessary for the diagnosis of fallopian tube patency following treatment of ovarian ectopic cysts.

Methods

A retrospective analysis of hysterosalpingography (HSG) examination data from 71 patients who had received sonography-guided interventional treatment for ovarian ectopic cysts at the Fourth Affiliated Hospital of Harbin Medical University was carried out. The 71 cases were divided into three groups. Four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) with the contrast agent SonoVue was carried out in the first group (4D-HyCoSy group), hydrogen peroxide (H2O2) examinations were carried out in the second group (H2O2 group), and the final group consisted of patients who underwent 4D-HyCoSy followed by an auxiliary H2O2 examination where necessary (4D-HyCoSy/H2O2 group). Results of these examinations were then compared to those of a standard HSG examination using lipiodol radiography that had been carried out a month beforehand.

Results

(1) The rates of diagnostic accordance with standard HSG examination results for the 4D-HyCoSy, H2O2, and 4D-HyCoSy/H2O2 groups were 86.9, 70.5 and 91.8% respectively. The H2O2 group accordance rate was significantly lower than that of the other two groups (p < 0.05). (2) Compared to the tubal patency results of the standard HSG examination, the sensitivity, specificity, positive predictive value, negative predictive value, and Youden index of the 4D-HyCoSy group were 83.3, 89.3, 83.3, 89.3, and 0.73% respectively. For the H2O2 group, these values were 66.7, 73.9, 70, 70.8, and 0.41%, respectively, and for the 4D-HyCoSy/H2O2 group were 90, 93.5, 90, 93.5, and 0.84%, respectively. All of these values were significantly higher in the 4D-HyCoSy/H2O2 group than in the other two groups.

Conclusions

The use 4D-HyCoSy with auxiliary H2O2 examination for the diagnosis of tubal patency is safe, non-invasive, and easy to carry out. It can also improve the diagnostic accuracy rate of 4D-HyCoSy and H2O2 examinations used on their own.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Wang LL, Cai HQ, Dong XQ, Zhang LW, Jiang SS, Zhao N, Shao XH, Wang SM, Zhu L, Zhang T (2015) Differentially expressed gene profiles in the serum before and after the ultrasound-guided ethanol sclerotherapy in patients with ovarian endometriomas. Clin Biochem 48(16–17):1131–1137

    Article  CAS  PubMed  Google Scholar 

  2. Shao XH, Zhang LW, Wang LL, Wang SM, Dong XQ (2015) Contrast-Enhanced sonographic features before and after interventional treatment of ovarian endometrial cysts. J Ultrasound Med Off J Am Instit Ultrasound Med 34(12):2133–2139

    Google Scholar 

  3. Hajishafiha M, Zobairi T, Zanjani VR, Ghasemi-Rad M, Yekta Z, Mladkova N (2009) Diagnostic value of sonohysterography in the determination of fallopian tube patency as an initial step of routine infertility assessment. J Ultrasound Med 28:1671–1677

    Article  PubMed  Google Scholar 

  4. Kupesic S, Plavsic BM (2007) 2D and 3D hysterosalpingo-contrast sonography in the assessment of uterine cavity and tubal patency. Eur J Obstet Gynecol Reprod Biol 133:64–69

    Article  PubMed  Google Scholar 

  5. Cheong YC, Li TC (2005) Evidence-based management of tubal disease and infertility. Curr Obstet Gynaecol 15:306–313

    Article  Google Scholar 

  6. Aboulghar MA, Mourad LM, Al-Inany HG, Aboulghar MM, Mansour RT, Serour GA (2010) Prospective randomized study for hydrotubation versus no hydrotubation before intrauterine insemination in unexplained infertility. Reprod Bio Med Online 20(4):543–546

    Article  Google Scholar 

  7. Testa AC, Timmerman D, Van Belle V, Fruscella E, Van Holsbeke C, Savelli L, Ferrazzi E, Leone FP, Marret H, Tranquart F, Exacoustos C, Nazzaro G, Bokor D, Magri F, Van Huffel S, Ferrandina G, Valentin L (2009) Intravenous contrast ultrasound examination using contrast-tuned imaging (CnTI) and the contrast medium SonoVue for discrimination between benign and malignant adnexal masses with solid components. Ultrasound Obstet Gynecol 34:699–710

    Article  CAS  PubMed  Google Scholar 

  8. Kong D, Dong X, Qi Y (2015) Ultrasonography-guided multidrug stratification interventional therapy for cesarean scar pregnancy. Arch Gynecol Obstet 292(1):143–148

    Article  PubMed  Google Scholar 

  9. Marret H, Sauget S, Giraudeau B, Brewer M, Ranger-Moore J, Body G, Tranquart F (2004) Contrast-enhanced sonography helps in discrimination of benign from malignant adnexal masses. J Ultrasound Med 23:1629–1639

    Article  PubMed  Google Scholar 

  10. Emoto M, Fujimitsu R, Hiwasaki H, Kawarabayashi T (2003) Normal sized ovarian cancer detected by colour Doppler ultrasound using a microbubble contrast agent. J Clin Oncol 21:3703–3705

    Article  PubMed  Google Scholar 

  11. Lessey BA (2013) Endometrial assessment: a clinical guide. Womens Health (Lond Engl) 9(5):415–417

    Article  CAS  Google Scholar 

  12. Wang LL, Dong XQ, Shao XH, Wang SM (2011) Ultrasound-guided interventional therapy for recurrent ovarian chocolate cysts. Ultrasound Med Biol 37(10):1596–1602

    Article  PubMed  Google Scholar 

  13. Wang SM, Cai HQ, Dong XQ, Fan QL, Wang LL, Shao XH, Zhang LW (2015) Correlation between ovarian chocolate cyst and serum carbohydrate antigen 125 level and the effect of ultrasound-guided interventional sclerotherapy on serum carbohydrate antigen 125 level. J Obstet Gynaecol Res 41(1):92–98

    Article  CAS  PubMed  Google Scholar 

  14. Schankath AC, Fasching N, Urech-Ruh C, Hohl MK, Kubik-Huch RA (2012) Hysterosalpingography in the workup of female infertility: indications, technique and diagnostic findings. Insights Imaging 3:475–483

    Article  PubMed  PubMed Central  Google Scholar 

  15. Evers JL, Land JA, Mol BW (2003) Evidence-based medicine for diagnostic questions. Semin Reprod Med 21:9–15

    Article  PubMed  Google Scholar 

  16. Saunders RD, Shwayder JM, Nakajima ST (2011) Current methods of tubal patency assessment. Fertil Steril 95:2171–2179

    Article  PubMed  Google Scholar 

  17. Exacoustos C, Di Giovanni A, Szabolcs B, Binder-Reisinger H, Gabardi C, Arduini D (2009) Automated sonographic tubal patency evaluation with three-dimensional coded Contrast imaging (CCI) during hysterosalpingo-contrast sonography (HyCoSy). Ultrasound Obstet Gynecol 34:609–612

    Article  CAS  PubMed  Google Scholar 

  18. Zhou L, Zhang X, Chen X, Liao L, Pan R, Zhou N, Di N (2012) Value of three-dimensional hysterosalpingo-contrast sonography with SonoVue in the assessment of tubal patency. Ultrasound Obstet Gynecol 40:93–98

    Article  CAS  PubMed  Google Scholar 

  19. Luciano DE, Exacoustos C, Johns DA, Luciano AA (2011) Can hysterosalpingo- contrast sonography replace hysterosalpingography in confirming tubal blockage after hysteroscopic sterilization and in the evaluation of the uterus and tubes in infertile patients? Am J Obstet Gynecol 204:79–84

    Article  PubMed  Google Scholar 

  20. Corson SL, Cheng A, Gutmann JN (2000) Laparoscopy in the “normal” infertile patient: a question revisited. J Am Assoc Gynecol Laparosc 7:317–324

    Article  CAS  PubMed  Google Scholar 

  21. Dietrich M, Suren A, Hinney B, Osmers R, Kuhn W (1996) Evaluation of tubal patency by HysterocontrastSonography (HyCoSy, Echovist) and its correlation with laparoscopic findings. J Clin Ultrasound 24:523–527

    Article  CAS  PubMed  Google Scholar 

  22. Exacoustos C, Zupi E, Carusotti C, Lanzi G, Marconi D, Arduini D (2003) Hysterosalpingo-contrast sonography compared with hysterosalpingography and laparoscopic dye perturbation to evaluate tubal patency. J Am Assoc of Gynecol Laparosc 10:29–32

    Google Scholar 

  23. Exacoustos C, Zupi E, Szabolcs B et al (2009) Contrast-tuned imaging and second-generation contrast agent SonoVue: a new ultrasound approach to evaluation of tubal patency. J Minim Invasive Gynecol 16:437–444

    Article  PubMed  Google Scholar 

  24. Lanzani C, Savasi V, Leone FP, Ratti M, Ferrazzi E (2009) Two-dimensional HyCoSy with contrast tuned imaging technology and a second-generation contrast media for the assessment of tubal patency in an infertility program. Fertil Steril 92:1158–1161

    Article  CAS  PubMed  Google Scholar 

  25. Testa AC, Ferrandina G, Fruscella E, Van Holsbeke C, Ferrazzi E, Leone FP, Arduini D, Exacoustos C, Bokor D, Scambia G, Timmerman D (2005) The use of contrasted transvaginal sonography in the diagnosis of gynecologic diseases: a preliminary study. J Ultrasound Med 24:1267–1278

    Article  PubMed  Google Scholar 

  26. Exacoustos C, Di Giovanni A, Szabolcs B, Romeo V, Romanini ME, Luciano D, Zupi E, Arduini D (2013) Automated three-dimensional coded contrast imaging hysterosalpingo-contrast sonography: feasibility in office tubal patency testing. Ultrasound Obstet Gynecol 41(3):328–335

    Article  CAS  PubMed  Google Scholar 

  27. Socolov D, Boian I, Boiculese L, Tamba B, Anghelache-Lupascu I, Socolov R (2010) Comparison of the pain experienced by infertile women undergoing hysterosalpingo contrast sonography or radiographic hysterosalpingography. Int J Gynaecol Obstet 111:256–259

    Article  PubMed  Google Scholar 

  28. He Yanni, Geng Qiang, Liu Hongmei, Han Xiaohua (2013) First experience using 4-dimensional hysterosalpingo-contrast sonography with sonoVue for assessing fallopian tube patency. J Ultrasound Med 32:1233–1243

    Article  PubMed  Google Scholar 

  29. Zhou L, Zhang X, Chen X et al (2012) Value of three-dimensional hystero -salpingo-contrast sonography with SonoVue in the assessment of tubal patency. Ultrasound Obstet Gynecol 40:93–98

    Article  CAS  PubMed  Google Scholar 

  30. Luo LL (1990) Ultrasonic study with hydrotubation of tubal patency. Zhonghua Fu Chan Ke Za Zhi 25(3):149–151

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was funded by the grant from Scientific and Technological Projects in Heilongjiang Province of China (Grant Number GC12C306-4).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Xiaoqiu Dong.

Ethics declarations

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kong, D., Dong, X., Wang, Z. et al. Four-dimensional hysterosalpingo-contrast sonography with auxiliary hydrogen peroxide examination for the diagnosis of fallopian tube patency following interventional treatment of ovarian ectopic cysts. Arch Gynecol Obstet 295, 519–526 (2017). https://doi.org/10.1007/s00404-016-4259-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-016-4259-7

Keywords

Navigation