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Li Y, Chen X, Wang Q, Wang J. Factors Influencing the Visualization of Fallopian Tubes in Hysterosalpingo-Contrast Sonography (HyCoSy)-The Value of Multimodal HyCoSy in Visualizing the Fallopian Tubes. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024. [PMID: 39031455 DOI: 10.1002/jum.16530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/28/2024] [Accepted: 07/01/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) can non-invasively evaluate the patency of the fallopian tubes and is increasingly used in clinical practice. However, some factors may lead to false-positive diagnoses. This study aims to analyze the factors affecting clear imaging of the fallopian tubes in 4D-HyCoSy and explore methods to improve the quality of fallopian tube imaging. METHODS A total of 118 patients were enrolled in this retrospective study. After injecting the SonoVue into the uterine cavity, three modes of HyCoSy were completed in sequence: 4D-HyCoSy, 2D-HyCoSy, and second harmonic imaging (SHI). Participants were divided into two groups: the easy visualization group (fallopian tubes could be visualized using only 4D-HyCoSy) and the difficult visualization group (a multimodal combination was required for visualization). The position of the uterus, the relationship between the ovaries and the uterus, endometrial thickness, time of catheterization in the uterine cavity, presence or absence of lesions in the uterine cavity, whether intestinal gas covers the fallopian tubes and the imaging effect of different modes on the fallopian tubes was analyzed, to determine the key factors affecting the clear imaging of the fallopian tubes. RESULTS The positional relationship between the ovary and the uterus (OR = 4.711, 95% CI: 1.322-19.77, P = 0.023), the positioning of the uterus (OR = 3.843, 95% CI: 1.129-15.26, P = 0.04), endometrial thickness (OR = 3.985, 95% CI: 1.168-15.99, P = 0.036), and the duration of intrauterine catheter placement (OR = 3.547, 95% CI: 1.042-13.52, P = 0.05) were independent factors that affecting difficulty in visualizing the fallopian tubes. CONCLUSION Uterine position, the positional relationship between the ovary and the uterus, endometrial thickness, and the time of catheter insertion are factors that affect visualizing the fallopian tubes during 4D-HyCoSy. The combination of multimodal imaging, especially the combination of 4D-HyCoSy with SHI mode, can help improve the quality of fallopian tube visualization.
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Affiliation(s)
- Yan Li
- Department of Ultrasound, The First Clinical Medical College of Anhui University of Traditional Chinese Medicine, Anhui, China
| | - Xiaoyi Chen
- Department of Ultrasound, The First Clinical Medical College of Anhui University of Traditional Chinese Medicine, Anhui, China
| | - Qin Wang
- Department of Ultrasound, The First Clinical Medical College of Anhui University of Traditional Chinese Medicine, Anhui, China
| | - Jingping Wang
- Department of Ultrasound, The First Clinical Medical College of Anhui University of Traditional Chinese Medicine, Anhui, China
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Qu E, Zhang M, Ju J, Chen Y, Lin X, Zhang X. Is Hysterosalpingo-Contrast Sonography (HyCoSy) Using Sulfur Hexafluoride Microbubbles (SonoVue) Sufficient for the Assessment of Fallopian Tube Patency? A Systematic Review and Meta-Analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:7-15. [PMID: 35441714 DOI: 10.1002/jum.15988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/27/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
This study aimed to evaluate the diagnostic value of HyCoSy using sulfur hexafluoride microbubbles for fallopian tubal patency assessment in infertile females. Twenty-four studies, including 1358 females with 2661 detected fallopian tubes published from January 2003 to May 2019, were identified. The pooled sensitivity was 93% (95% CI: 90-95%), while the specificity was 90% (95% CI: 87-92%). The area under the receiver-operating characteristic curve was 0.96 (95% CI: 94-98%). The specificity of the four-dimensional HyCoSy subgroup was higher than the 2D/3D subgroup; an increased dose of contrast agent did not affect the specificity, with only a slightly reduced sensitivity.
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Affiliation(s)
- Enze Qu
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Man Zhang
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jinxiu Ju
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ying Chen
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xin Lin
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xinling Zhang
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Qiang Y, Wu Y, Cai T. Clinical Significance of Increasing Pressure Curve's Slope When Injecting Ultrasound Contrast Agent During Evaluation of Fallopian Tubal Patency. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:2329-2338. [PMID: 33421176 DOI: 10.1002/jum.15616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the association between Fallopian tubal patency and the slope of the increasing pressure curve for ultrasound contrast agent. MATERIALS AND METHODS A total of 136 patients underwent transvaginal 4-dimensional hysterosalpingo-contrast sonography (TVS 4D HyCoSy) between August 2015 and January 2016. We divided the patients into 3 groups according to different Fallopian tubal patency status: 71 patients (48.97%) in bilateral tubal patency group, 45 (31.03%) in unilateral tubal patency group, and 20 in bilateral tubal nonpatent group. The ultrasound contrast agent was injected and the pressure curve was recorded automatically in real time using a liquid-injecting machine that traces it as a pressure curve. The slopes of the different groups are compared through independent sample t test. RESULTS The slopes of the 3 groups were 1.242 ± 0.572, 1.472 ± 0.638, and 2.068 ± 1.236 kPa/s. A correlation was observed between the slope of the increasing pressure curve and tubal patency (R = 0.287, P < .05). The slopes differed significantly between the bilateral tubal patency group and bilateral tubal nonpatent group (P = .001) and between the unilateral tubal patency group and bilateral tubal nonpatent group (P = .012). However, the difference between the bilateral tubal patency and unilateral tubal patency groups was not significant (P = .266). CONCLUSION The increase of the injecting pressure curve's slope for contrast agent during 4D HyCoSy is associated with the nonpatent degree of the tube. This condition can be used as an objective index of tubal patency and can be a reference in diagnosis and treatment.
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Affiliation(s)
- Ye Qiang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Qinhuai District, Nanjing 210029, Jiangsu Province, China
| | - Yiyun Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Qinhuai District, Nanjing 210029, Jiangsu Province, China
| | - Ting Cai
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Qinhuai District, Nanjing 210029, Jiangsu Province, China
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Magnetic Resonance Imaging Feature Analysis and Evaluation of Tubal Patency under Convolutional Neural Network in the Diagnosis of Infertility. CONTRAST MEDIA & MOLECULAR IMAGING 2021; 2021:5175072. [PMID: 34629993 PMCID: PMC8464418 DOI: 10.1155/2021/5175072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022]
Abstract
To explore the diagnostic value of MRI image features based on convolutional neural network for tubal unobstructed infertility, 30 infertile female patients were first selected as the research objects, who admitted to the hospital from May 2018 to January 2020. They all underwent routine MRI examinations and CNN-based MR-hysteron-salpingography (HSG) examinations, in order to discuss the diagnostic accuracy of the two examinations. In the research, it was necessary to observe the patients' imaging results, calculate the diagnosis rate of the two examination results, and analyze the application effect of the CNN algorithm, thereby selecting the best reconstruction method. In this study, the analysis was conducted on the basis of no statistical difference in the baseline data of the included patients. The results of undersampling reconstruction at 2-fold, 4-fold, and 6-fold showed that CNN for data consistency layer (CNN_DC) had a better effect, and its peak signal-to-noise ratio (PSNR) was lower sharply than that of the other two reconstruction methods, while the normalized mean square error (NMSE) and structural similarity index measure (SSIM) were higher markedly than the values of the other two reconstruction methods. The diagnostic rate of routine MRI examination of the fallopian tube and other parts of the uterus was lower than or equal to that of MR-HSG examination by CNN. Routine MRI examinations of fallopian tube imaging artifacts were large, and the definition was reduced, which increased the difficulty of identification. However, MR-HSG examination by CNN indicated that the imaging artifacts were low, the clarity was high, and the influence of noise was small, which was conducive to clinical diagnosis and identification. For endometriosis, the accuracy of MR-HSG was 33.33% and the accuracy of MRI was 46.67%. CNN MR-HSG inspection method was significantly better than the conventional MRI inspection method (P < 0.05). Therefore, the results of this study revealed that MR-HSG examination by CNN had a clear imaging effect and obvious inhibition effect on background signals and rapid image generation without the need for reconstruction with the same spatial resolution, which improved the imaging quality and could provide a reference value for clinical diagnosis and subsequent related studies.
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Guo X, Zhang Z, Liu Z, Fu H, Gao X, Yang H, Gao P, Li X, Ai W, He Z, Du D. Assessment of the Contrast-Enhanced Ultrasound in Percutaneous Nephrolithotomy for the Treatment of Patients with Nondilated Collecting System. J Endourol 2020; 35:436-443. [PMID: 32935565 DOI: 10.1089/end.2020.0564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: To investigate the clinical value of contrast-enhanced ultrasound (CEUS) in percutaneous nephrolithotomy (PCNL) for kidney stone patients without hydronephrosis. Methods: Patients with nondilated collecting system kidney stones who underwent PCNL between October 2018 and December 2019 at our hospital were enrolled in this study. Patients who met the inclusion criteria were randomized into two groups: a CEUS-guided PCNL group and a conventional ultrasound (US)-guided PCNL group. The operation results of the two groups were compared, including the number of attempts for effective puncture, duration to effective puncture, stone clearance rate, blood loss, postoperative complications, and hospital stay. Results: Fifty-six patients with a nondilated collecting system who underwent PCNL for 60 kidneys were included in this study, including 4 patients who underwent bilateral PCNL due to bilateral renal stones. There were 30 kidneys in each group. All patients successfully underwent PCNL. The CEUS-guided PCNL group had more accurate punctures, with a higher effective rate of one puncture and shorter puncture time. There was no statistically significant difference in stone clearance rate between the two groups. Four cases of double channels were established in the conventional US-guided PCNL group, while there was only one case in the CEUS-guided PCNL group. In the CEUS-guided PCNL group, most cases (96.7%, 29/30) had no or only mild complications, which were significantly better than the conventional US-guided PCNL group (76.7%, 23/30). The mean postoperative hemoglobin loss in the CEUS-guided PCNL group was 9.5 (range 1-25) g/L, which was significantly lower than 15.5 (range 5-52) g/L in the conventional US-guided PCNL group. Conclusion: The CEUS technique can improve visibility of the nondilated renal collecting system, facilitate selection of suitable calix, and identify renal calix fornix. It also benefits needle placement in patients with a nondilated collecting system.
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Affiliation(s)
- Xiong Guo
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Zhi Zhang
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Zonglai Liu
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Haibo Fu
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Xiaozhan Gao
- Department of Ultrasound, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Han Yang
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Pan Gao
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Xinyu Li
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Wei Ai
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Ziqiu He
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
| | - Dan Du
- Department of Urology, The Second People's Hospital of China Three Gorges University, The Second People's Hospital of Yichang, Yichang, China
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Wang L, Lu M, Wu X, Cheng X, Li T, Jiang Z, Shen Y, Liu T, Ma Y. Contrast-enhanced ultrasound-guided celiac plexus neurolysis in patients with upper abdominal cancer pain: initial experience. Eur Radiol 2020; 30:4514-4523. [PMID: 32211966 DOI: 10.1007/s00330-020-06705-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/29/2019] [Accepted: 02/03/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the efficacy and safety of contrast-enhanced ultrasound (CEUS)-guided celiac plexus neurolysis (CPN) in patients with upper abdominal cancer pain. METHODS Thirty-five patients with upper abdominal cancers tortured by intractable upper abdominal pain underwent CEUS-guided CPN with ethanol. The pain alleviation and opioid intake were observed and evaluated during a 3-month follow-up after CPN. The dispersion of alcohol around the aorta was evaluated on 3D-CEUS. Complications were assessed during CPN and at follow-up. RESULTS All of the 35 patients' CPN was successfully achieved. Pain relief was observed in 28 (80%), 20 (57.1%), 27 (77.1%), 20 (57.1%), and 10 (29.4%) patients immediately, 1 day, 1 month, 2 months, and 3 months after CPN, respectively. The agent dispersion around the aorta on CEUS images of 28 patients who showed pain relief was at least 90° of the circumference around the aorta. The median duration of pain alleviation was 2.7 months (95% confidence interval [CI], 2.5-2.9). Less than half of the patients had minor complications including irritant pain at the puncture site (8 of 35; 22.9%), diarrhea (4 of 35; 11.4%), nausea and vomiting (3 of 35; 8.6%), and post-procedural hypotension (1 of 35; 2.9%). CONCLUSIONS CEUS-guided CPN is a safe and effective method to alleviate refractory upper abdominal pain in patients with upper abdominal cancers. CEUS image allows the visualization of puncture path and observation of drug dispersion. The pain relief is relevant to the dispersion of neurolytic agent around the aorta. KEY POINTS • CEUS-guided celiac plexus neurolysis (CPN) is feasible and easy. • It allows direct visualization of the diffusion of the neurolytic agent in the retroperitoneal anatomic space. • CEUS-guided CPN improves safety of CPN by clearly delineating the needle path.
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Affiliation(s)
- Lu Wang
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Man Lu
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China.
| | - Xiaobo Wu
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Xueqing Cheng
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Tingting Li
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Zirui Jiang
- Electrical and Computer Engineering, University of Wisconsin Madison, Madison, 53703, USA
| | - Yuping Shen
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Ting Liu
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Yue Ma
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
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Shi J, Li S, Wu H, He Y, Yi W, Xu J, Liu H, Guan Y. The Influencing Factors of Venous Intravasation During Transvaginal Four-dimensional Hysterosalpingo-contrast Sonography With SonoVue. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2273-2280. [PMID: 31201020 DOI: 10.1016/j.ultrasmedbio.2019.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/17/2019] [Accepted: 05/06/2019] [Indexed: 06/09/2023]
Abstract
Transvaginal 4-D hysterosalpingo-contrast sonography with SonoVue (TV 4-D HyCoSy) is the preferred imaging method for evaluating tubal patency. However, venous intravasation in 4-D HyCoSy may affect the diagnosis of tubal patency. The objective of this study was to analyze influencing factors of venous intravasation during TV 4-D HyCoSy. This study included 643 infertile patients who underwent TV 4-D HyCoSy. We analyzed the relationship between the incidence of venous intravasation and patients' basic clinical data, endometrial thickness, inspection timing (clean day of menstruation) and tubal patency. A total of 169 (26.28%) patients exhibited intravasation during TV 4-D HyCoSy. The following are risk factors for venous intravation: secondary infertility, type C + C, type B + C and type B + B in bilateral fallopian tubal patency grouping; endometrial thickness ≤5.45 mm; and taking TV 4-D HyCoSy after menstruation ≤6 d. Infertility duration, intrauterine lesions, a history of pelvic inflammatory disease and a history of pelvic surgery were uncorrelated with venous intravasation. To reduce the incidence of venous intravasation, TV 4-D HyCoSy should be performed 7-10 d after menstruation or when endometrial thickness is thicker than 5.45 mm.
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Affiliation(s)
- Jiayao Shi
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, P.R. China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, P.R.China
| | - Sushu Li
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, P.R. China
| | - Haorong Wu
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, P.R. China
| | - Yanni He
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, P.R. China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, P.R.China
| | - Wenhong Yi
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, P.R. China
| | - Jingjiao Xu
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, P.R. China
| | - Hongmei Liu
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, P.R. China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, P.R.China.
| | - Ying Guan
- Department of Biostastics, Southern Medical University, Guangzhou, Guangdong, P.R. China
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Li J, Lu M, Cheng X, Hu Z, Li H, Wang H, Jiang J, Li T, Zhang Z, Zhao C, Ma Y, Tan B, Liu J, Yu Y. How Pre-operative Sentinel Lymph Node Contrast-Enhanced Ultrasound Helps Intra-operative Sentinel Lymph Node Biopsy in Breast Cancer: Initial Experience. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1865-1873. [PMID: 31101445 DOI: 10.1016/j.ultrasmedbio.2019.04.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 03/28/2019] [Accepted: 04/01/2019] [Indexed: 05/25/2023]
Abstract
We aimed to evaluate the value of sentinel lymph node contrast-enhanced ultrasound (SLN-CEUS) and surface tracing for the biopsy of intra-operative sentinel lymph nodes (SLNs). Between June 2015 and December 2017, a total of 453 patients with early invasive breast cancer were recruited. Patients received an intradermal injection of microbubble contrast agent around the areola on the day before surgery. The locations and sizes of lymphatic channels (LCs) and SLNs were marked on the body surface using gentian violet. Then, injection of double blue dye was performed half an hour before surgery. We compared the pathway of LCs and the location of SLNs obtained from SLN-CEUS and blue dye during surgery. Among the 453 patients, the mean numbers of LCs and SLNs detected by SLN-CEUS were 1.42 and 1.72, respectively, and the coincidence rate was 98.2% compared with blue dye during surgery. The median distance from the SLN to skin measured by pre-operative CEUS and blue dye was 1.95 ± 0.69 and 2.03 ± 0.87 cm (p = 0.35). There were three SLN enhancement in our research, including homogeneous enhancement, inhomogeneous enhancement and no enhancement, with the sensitivity, specificity, positive predictive value and negative predictive value of SLN-CEUS for the diagnosis of SLNs being 96.82%, 91.91%, 87.54% and 98.01%, respectively. SLN-CEUS with skin marking can identify the pathway of LCs and the location of the SLN before surgery, measure the distance from the SLN to skin and determine if the SLN is metastatic. SLN-CEUS can be used as an effective complement to the blue dye method.
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Affiliation(s)
- Juan Li
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Man Lu
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Xueqing Cheng
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ziyue Hu
- North Sichuan Medical College, Nanchong, China
| | - Hui Li
- Breast Surgeons Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hao Wang
- Breast Surgeons Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingzhen Jiang
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tingting Li
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhenqi Zhang
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Caihong Zhao
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yue Ma
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Bo Tan
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingping Liu
- Breast Surgeons Department, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuan Yu
- Breast Surgeons Department, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Influence of a mannose-binding lectin gene polymorphism and exposure to Chlamydia trachomatis on fallopian tube obstruction in Brazilian woman. Arch Gynecol Obstet 2019; 300:641-645. [PMID: 31286209 DOI: 10.1007/s00404-019-05231-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Factors influencing fallopian tube occlusion in women with a lower genital tract infection remain incompletely elucidated. We evaluated whether a polymorphism in the mannose-binding lectin (MBL) gene at codon 54 influences the occurrence of fallopian tube blockage in relation to exposure to Chlamydia trachomatis. METHODS In a case-control study at The Hospital das Clínicas, University of São Paulo, Brazil, 75 women with hysterosalpingography-documented tubal occlusion and 75 women with patent fallopian tubes were analyzed for detection of single-nucleotide polymorphism in codon 54 of the MBL gene and for IgG anti-C. trachomatis antibodies in their sera. Both groups were matched for age, race, and sexual variables. RESULTS Prior exposure to C. trachomatis, as evidenced by the presence of IgG antibodies, was comparable in both groups. Detection of the polymorphic MBL allele was more prevalent in women with blocked tubes (p < 0.01), regardless of whether or not there was evidence of prior chlamydial exposure. CONCLUSION The level of MBL-related innate immunity influences the consequences of infection by C. trachomatis or other microbes.
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Wang X, Dou C, Yan Y, Song L, Hu B, Ying T. Preoperative Transurethral Contrast-Enhanced Ultrasonography in the Diagnosis of Female Urethral Diverticula. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:2881-2889. [PMID: 29689620 DOI: 10.1002/jum.14648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/28/2018] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To explore the value of transurethral contrast-enhanced ultrasonography (CEUS) in the diagnosis and evaluation of female urethral diverticula. METHODS This study prospectively enrolled 35 women with periurethral cystic lesions, who underwent preoperative transurethral CEUS at our single center between April 2015 and May 2017. The diagnosis of a urethral diverticulum was made by the detection of microbubbles inside the lesion. Data regarding the structure and ostia of the diverticula were collected and then compared with intraoperative findings. RESULTS The median (interquartile range) age of the 35 patients was 43 (34-48) years. The most common manifestations were dysuria (43%) and palpable masses (40%). On transurethral CEUS, 20 patients were found to have urethral diverticula. The diverticula involved the proximal, mid, and distal urethra with different sizes. The shapes of the diverticula were simple in 4 patients (20%), U shaped in 8 patients (40%), and circumferential in 8 patients (40%). A total of 23 ostia were identified. Seventeen women (85%) had 1 ostium, and 3 women (15%) had 2 ostia. Twenty-one diverticular ostia (91%) were located from the 3- to 9-o'clock positions. The median (interquartile range) distance from the diverticular ostia to the bladder neck was 20 (9-31) mm. During surgery, all US presentations correlated well with surgical findings, and 21 patients were confirmed to have urethral diverticula. The transurethral CEUS had sensitivity of 95% and specificity of 100%. CONCLUSIONS Transurethral CEUS is an effective method for identifying the structure and ostium of female urethral diverticula. It may have a potential role in preoperative planning and surgical management.
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Affiliation(s)
- Xia Wang
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Chaoran Dou
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yulin Yan
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lujie Song
- Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Bing Hu
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Tao Ying
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Contrast-enhanced ultrasound (CEUS) nephrostogram: utility and accuracy as an alternative to fluoroscopic imaging of the urinary tract. Clin Radiol 2018; 74:167.e9-167.e16. [PMID: 30415765 DOI: 10.1016/j.crad.2018.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/10/2018] [Indexed: 12/19/2022]
Abstract
AIM To establish the feasibility and accuracy of contrast-enhanced ultrasound (CEUS) nephrostogram in comparison to the reference standard, fluoroscopic nephrostogram, in providing alternative imaging of the urinary tract post-nephrostomy insertion. MATERIALS AND METHODS This prospective study was approved by the institutional and national ethics committee. All patients for whom a fluoroscopic nephrostogram was requested were included. Fluoroscopic and CEUS nephrostograms were performed within 24 hours. Image analysis (nephrostomy position, opacification of pelvicalyceal system, ureter, and bladder) was performed by two reviewers, and the diagnostic accuracy of the CEUS nephrostograms was compared to fluoroscopic nephrostograms. RESULTS Sixty-two nephrostograms were performed in 48 patients from June 2011 to April 2016, (male: 25/48, 52.1%; mean age 65 years, range 28-90 years). Indications for nephrostomy were: malignancy (29/62; 46.8%), benign ureteric stricture (14/62; 22.6%), urinary diversion (8/62; 12.9%), renal calculus (5/62; 8.1%), haematoma (3/62; 4.8%) or pelvi-ureteric junction obstruction (3/62; 4.8%). Two nephrostomies were identified as displaced by both techniques. The pelvicalyceal system was visualised in 60/60 (100%) examinations in both fluoroscopic and CEUS nephrostograms. The entire ureter was visualised in 30/60 (50%) with CEUS compared to 32/60 (53.3%) fluoroscopically. The distal ureter was the least well-visualised segment for both techniques with no significant difference (p=0.815). Both CEUS and fluoroscopy could be used to correctly identify complications including entero-ureteric fistula or urine leak. Fluoroscopic nephrostogram demonstrated drainage into the bladder in 33/60 (55%), CEUS confirmed drainage in 34/60 (56.7%) cases (p=0.317). CONCLUSIONS CEUS nephrostogram can determine the correct positioning of a nephrostomy and assess drainage into the bladder with statistically comparable results to fluoroscopy.
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Ferreira TAC, Fornazari G, Saldanha A, Lunardeli B, Moore BA, Montiani-Ferreira F. The use of sulfur hexafluoride microbubbles for contrast-enhanced ocular ultrasonography of the pecten oculi in birds. Vet Ophthalmol 2018; 22:423-429. [PMID: 30109756 DOI: 10.1111/vop.12608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 06/20/2018] [Accepted: 07/19/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND The pecten oculi is a vascular and pigmented structure localized within the posterior segment of all avian eyes. Its primary function is not fully understood yet. OBJECTIVE As ultrasonography (US) is a useful imaging modality for evaluation of the pecten oculi, the objective of this study was to investigate the utility of an intravenous contrast solution of sulfur hexafluoride (SF6) microbubbles as a means of enhancing visualization of the pecten oculi in normal birds. ANIMALS STUDIED Ten adult individuals of the following avian species were evaluated: 1 roadside hawk (Rupornis magnirostris), 1 stygian owl (Asio stygius), 2 striped owls (Asio clamator), 2 burrowing owls (Athene cunicularia), 2 ring-necked parakeet (Psittacula krameri), and 2 domestic chickens (Gallus gallus domesticus). PROCEDURE(S) After baseline ocular sonograms were obtained in sedated animals, 4.5 μg/kg of a contrast solution containing SF6 microbubbles was administered intravenously and US of the right eye was immediately performed. US was continued during injection to provide real-time imaging of the pecten oculi during vascular perfusion of contrast material. RESULTS Within 2-3 seconds following intravenous contrast administration, microbubbles reached the pecten oculi of all birds investigated and provided significant ultrasonographic contrast enhancement. CONCLUSIONS SF6 microbubble contrast ultrasonography in birds is a safe and easy procedure that provides increased contrast and enhanced visualization of the pecten oculi. Future use may enable further discovery of its physiologic functions and aid in the development of therapeutic plans for avian intraocular disease.
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Affiliation(s)
| | | | - André Saldanha
- Comparative Ophthalmology Lab (LABOCO), Curitiba-PR, Brazil
| | | | - Bret A Moore
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, California
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Wang W, Zhou Q, Gong Y, Li Y, Huang Y, Chen Z. Assessment of Fallopian Tube Fimbria Patency With 4-Dimensional Hysterosalpingo-Contrast Sonography in Infertile Women. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:2061-2069. [PMID: 28543598 DOI: 10.1002/jum.14244] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 01/13/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the performance of 4-dimensional (4D) hysterosalpingo-contrast sonography (HyCoSy) for assessing fallopian tube fimbria patency in infertile women. METHODS Seventy-seven infertile female patients with obstruction at the tubal fimbria or partial obstruction with pelvic adhesions were included. All of the patients underwent 4D HyCoSy enhanced by dynamic observation after a flush of normal saline and were followed with laparoscopic chromopertubation using methylene blue within 6 months. RESULTS The overall accordance between 4D HyCoSy and laparoscopic chromopertubation was 92.9%. The sensitivity and specificity of 4D HyCoSy with laparoscopic chromopertubation as a reference standard were 93.8% and 92.2%, respectively. CONCLUSIONS Four-dimensional HyCoSy can be the preferred method for assessment of tubal fimbria patency and pelvic adhesions surrounding the ovaries, with its advantages of accuracy, noninvasiveness, and a good safety profile.
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Affiliation(s)
- Weiqun Wang
- Department of Ultrasound Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiulan Zhou
- Department of Ultrasound Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yafei Gong
- Department of Ultrasound Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ying Li
- Department of Ultrasound Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yinying Huang
- Department of Ultrasound Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhiyi Chen
- Department of Ultrasound Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Cheng X, Zhang Z, Xuanyan G, Li T, Li J, Yin L, Lu M. Adhesive Capsulitis of the Shoulder: Evaluation With US-Arthrography Using a Sonographic Contrast Agent. Sci Rep 2017; 7:5551. [PMID: 28717193 PMCID: PMC5514045 DOI: 10.1038/s41598-017-05491-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/30/2017] [Indexed: 11/09/2022] Open
Abstract
Adhesive capsulitis (AC) is a painful and disabling disorder, which caused restricted motion and chronic pain of shoulder. Intracavitary contrast-enhanced ultrasound has been recently applied to assess obstructive bile duct diseases, tubal patency, vesicoureteric reflux and so on. The aim of this study was to detect the value of US-arthrography by injecting the contrast agent SonoVue into glenohumeral joint compared with US in diagnosing AC. Utrasound (US) and US-arthrography images of 45 patients with AC were compared with that of 45 control subjects without AC with MRI as a gold standard. Patients with AC had a significantly thickened coracohumeral ligment (CHL, 3.1 mm) and inferior capsule (3.5 mm) on US, and a decreased volume of axillary recess (1.14 ml) on US-arthrography compared with the control subjects (1.59 ml). Filling defect (91.1%) and synovitis-like abnormality (75.6%) in the joint on US-arthrography were more sensitive than that of rotator interval abnormality (71.1%), thickened CHL more than 3 mm (64.4%), thickened inferior capsule more than 3.5 mm (66.7%) on US respectively for diagnosis of AC. Consequently, US-arthrography was more effective method than US for assessment of AC. Filling defects of joint cavity and synovitis-like abnormality in the joint are characteristic US-arthrography findings for diagnosing AC.
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Affiliation(s)
- Xueqing Cheng
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhenqi Zhang
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Guo Xuanyan
- Department of Ultrasound, Sichuan Academy of Medical Sciences & Sichuan Provincal People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tingting Li
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Juan Li
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Longlin Yin
- Department of Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Man Lu
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
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Exacoustos C, Pizzo A, Lazzeri L, Pietropolli A, Piccione E, Zupi E. Three-Dimensional Hysterosalpingo Contrast Sonography with Gel Foam: Methodology and Feasibility to Obtain 3-Dimensional Volumes of Tubal Shape. J Minim Invasive Gynecol 2017; 24:827-832. [DOI: 10.1016/j.jmig.2017.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 04/05/2017] [Accepted: 04/14/2017] [Indexed: 11/24/2022]
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Wang J, Li J, Yu L, Han S, Shen X, Jia X. Application of 3D-HyCoSy in the diagnosis of oviduct obstruction. Exp Ther Med 2017; 13:966-970. [PMID: 28450927 PMCID: PMC5403485 DOI: 10.3892/etm.2017.4083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 12/19/2016] [Indexed: 11/06/2022] Open
Abstract
The aim of the study was to analyze the application value of three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) in the diagnosis of oviduct obstruction. Fifty-two patients with infertility and oviduct obstruction were continuously selected and treated with 3D-HyCoSy and CLP (CLP). It was found that according to CLP diagnosis, 40 oviducts were obstructed, 30 were partially obstructed, 12 were tortuous and 22 were completely obstructed. The 40 cases were unilaterally pathological, 24 were bilaterally pathological, 10 were diagnosed as congenital dysplasia, 35 were diagnosed as inflammation and 19 were diagnosed as tumor and cyst. Based on the diagnostic criteria of CLP, the diagnostic sensitivity, specificity, positive predictive values and negative predictive values of 3D-HyCoSy was 82.4, 88.3, 77.9 and 90.2%, respectively. The contrast agent flow time of oviduct obstruction (tortuosity and complete obstruction) as diagnosed by 3D-HyCoSy was significantly prolonged when compared with that of partial oviduct obstruction (P<0.05), and flow time of inflammation as diagnosed thereby was longer than that of congenital dysplasia, tumor and cyst. Following the diagnosis of inflammation, the shape of the contrast agent was tenuous, swollen, angled, rigid and distorted and the occurrence rate of inflammation was significantly higher (P<0.05). In conclusion, the diagnostic effect of 3D-HyCoSy on oviduct obstruction was more accurate and can show different features when diagnosing different types of inflammation, thus having a certain value for identifying the inflammation.
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Affiliation(s)
- Jinglei Wang
- Department of Ultrasound, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Jingbo Li
- Department of Ultrasound, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Ling Yu
- Department of Ultrasound, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Suhua Han
- Department of Ultrasound, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Xiaofang Shen
- Department of Ultrasound, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Xiao Jia
- Department of Ultrasound, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
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Hysterosalpingo-Contrast Sonography With Four-Dimensional Technique for Screening Fallopian Tubal Patency: Let's Make an Exploration. J Minim Invasive Gynecol 2017; 24:407-414. [DOI: 10.1016/j.jmig.2016.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/07/2016] [Accepted: 12/19/2016] [Indexed: 11/20/2022]
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Abstract
We present an overview of the common types of tubal patency tests, with a focus on hysterosalpingo-foam sonography (HyFoSy). Current evidence suggests that HyFoSy is an accurate alternative to X-ray hysterosalpingography (HSG) for outpatient tubal evaluation in women who are at low risk for tubal disease. It may be superior to saline hysterosalpingo-contrast sonography (HyCoSy) in excluding tubal occlusion. A hyperechogenic medium may enhance contrast visualization and enable clearer delineation of tubal anatomy. This may enhance confidence in the diagnosis of tubal patency, reduce false occlusion results, and improve the diagnostic yield of the test. It would be reasonable to deduce that HyFoSy would have similar performance characteristics as HyCoSy with other positive contrast agents. The available evidence supports the accuracy of HyFoSy compared to other forms of tubal investigation. We suggest a decision-making pathway based on the most current professional recommendations and available evidence. However, in this article, we do not provide a definitive exposition of the methods used for investigating tubal patency. Rather, we explore the contexts in which the various investigations are most and least suitable, and identify their strengths and limitations. Finally, we also discuss challenges encountered when performing tubal contrast sonography in clinical practice, including the problem of false occlusion results.
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Affiliation(s)
- Hemashree Rajesh
- Centre of Assisted Reproduction, Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore
| | - Serene Liqing Lim
- Centre of Assisted Reproduction, Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore
| | - Su Ling Yu
- Centre of Assisted Reproduction, Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore
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Kong D, Dong X, Wang Z, Zhang L, Shao X, Qi Y. 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 2016; 295:519-526. [DOI: 10.1007/s00404-016-4259-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/30/2016] [Indexed: 12/01/2022]
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Yu J, Cai M, Liang W, Deng Z, Xie Y. Diagnostic efficacy of 3-D hysterosalpingo-contrast sonography in the detection of tubal occlusion: Systematic meta-analysis. J Obstet Gynaecol Res 2015; 41:1418-25. [PMID: 26098684 DOI: 10.1111/jog.12728] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 03/01/2015] [Accepted: 03/06/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Jiangxiu Yu
- Department of Ultrasound Medicine; Third Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
| | - Mingjin Cai
- Department of Radiology; Third Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
| | - Weixiang Liang
- Department of Ultrasound Medicine; Third Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
| | - Zhifeng Deng
- Department of Intervention Radiology; Affiliated Baoan Hospital of Nanfang Medical University; Shenzhen Guangdong China
| | - Yinong Xie
- Department of Ultrasound Medicine; Third Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
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The effect of percutaneous ultrasound-guided subacromial bursography using microbubbles in the assessment of subacromial impingement syndrome: initial experience. Eur Radiol 2015; 25:2412-8. [PMID: 25744624 DOI: 10.1007/s00330-015-3638-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/14/2015] [Accepted: 01/21/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the feasibility and the value of percutaneous ultrasound-guided subacromial bursography (PUSB) with contrast-enhanced ultrasound (CEUS) for assessment of rotator cuff tears. METHODS Between January 2012 and September 2014, 2-D US and PUSB were prospectively performed in 135 patients with suspected rotator cuff tears from among 2,169 patients with clinically diagnosed subacromial impingement syndrome. Sixty-three patients who had undergone arthroscopy were included. The PUSB findings were compared with those from 2-D US using the McNemar test, with arthroscopy as a standard. RESULTS Of a total of 19 full-thickness tears (FTTs), 2-D US correctly diagnosed 12 and PUSB correctly diagnosed 18 (P = 0.031). With regard to partial-thickness tears, 2-D US correctly diagnosed 31 and PUSB 35 of a total of 41 tears (P = 0.375).Accuracy in diagnosing FTTs was 81.0 % for 2-D US and 98.4 % for PUSB. 2-D US and PUSB yielded sensitivity of 63.2 % and 94.7 %, respectively, for full-thickness tears, with specificity of 88.6 % and 100.0 %, respectively. CONCLUSIONS PUSB is a safe and feasible procedure, with greater sensitivity and specificity than 2D US in diagnosing FTTs As such, PUSB improves the value of ultrasound for assessing rotator cuff pathology. KEY POINTS • PUSB allows new application of CEUS and offers a new form of bursography. • PUSB appears to facilitate diagnosis of full -thickness rotator cuff tears. • PUSB outlines the rotator cuff tears more clearly than 2-D US.
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Van Schoubroeck D, Van den Bosch T, Ameye L, Boes AS, D'Hooghe T, Timmerman D. Pain during Fallopian-tube patency testing by hysterosalpingo-foam sonography. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2015; 45:346-350. [PMID: 25092501 DOI: 10.1002/uog.14646] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/20/2014] [Accepted: 07/22/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To evaluate perception of pain during Fallopian-tube patency testing by hysterosalpingo-foam sonography (HyFoSy). METHODS In this cross-sectional study, 216 consecutive women presenting at a university fertility clinic for HyFoSy examination were included. Patients were instructed to take ibuprofen 1 hour before the procedure. Immediately after the procedure, patients filled in a questionnaire concerning discomfort or pain experienced during the process, including a visual analog scale (VAS) score for perception of pain. RESULTS The median VAS score for perception of pain during transvaginal ultrasound examination and during HyFoSy examination was 1.5 (95% CI, 1.2-1.7) and 3.6 (95% CI, 3.0-4.0), respectively. One-third of women reported that the level of discomfort or pain during HyFoSy examination was similar to that during the preceding transvaginal ultrasound examination and 48% of women considered HyFoSy examination to be neutral/unpleasant, but not painful. There was an inverse association between both patients' age and parity and the pain experienced. CONCLUSIONS HyFoSy examination is tolerated well and allows for reliable tubal patency testing without exposing the patient to ionizing radiation in an outpatient setting with a low technical failure rate.
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Affiliation(s)
- D Van Schoubroeck
- Department of Development and Regeneration, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
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Müller T, Blank W, Leitlein J, Kubicka S, Heinzmann A. Endocavitary contrast-enhanced ultrasound: a technique whose time has come? JOURNAL OF CLINICAL ULTRASOUND : JCU 2015; 43:71-80. [PMID: 25349067 DOI: 10.1002/jcu.22250] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 09/07/2014] [Indexed: 06/04/2023]
Abstract
Endocavitary use of contrast agents in sonography (US) is a relatively new method in diagnostic imaging, competing against gray-scale US, fluoroscopy, and endoscopy. This article describes established indications, demonstrates the techniques of evolving applications, and discusses their potential benefits. These benefits include the ability to obtain precise information about the placement of drains and the extent of fluid collections, and to accurately identify the location and features of strictures in various organs, and those of complications of fluid collections or abscesses, without resorting to ionizing radiation.
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Affiliation(s)
- Thomas Müller
- Klinikum am Steinenberg, Medizinische Klinik I, Reutlingen, Germany
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Lo Monte G, Capobianco G, Piva I, Caserta D, Dessole S, Marci R. Hysterosalpingo contrast sonography (HyCoSy): let’s make the point! Arch Gynecol Obstet 2014; 291:19-30. [DOI: 10.1007/s00404-014-3465-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 09/09/2014] [Indexed: 11/28/2022]
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Sladkevicius P, Zannoni L, Valentin L. B-flow ultrasound facilitates visualization of contrast medium during hysterosalpingo-contrast sonography. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2014; 44:221-227. [PMID: 24375819 DOI: 10.1002/uog.13290] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/24/2013] [Accepted: 12/10/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess if B-flow ultrasound improves visualization of flow of contrast medium in the Fallopian tubes during hysterosalpingo-contrast sonography (HyCoSy) compared with grayscale ultrasound. METHODS This prospective observational study included 160 women referred for HyCoSy as part of infertility work-up between January 2011 and September 2012. In each woman, at the same session, HyCoSy was performed first using saline with air and then using Sonovue®, and for each contrast medium, grayscale ultrasound was first used and then B-flow ultrasound was used. Flow of contrast was observed in three parts of each tube: intramural, middle and distal. RESULTS In 129 (81%) women, flow of Sonovue was observed in the intramural part of both tubes and in the pouch of Douglas when using grayscale ultrasound. In these women, flow of Sonovue was seen in the middle part of 70% of the 258 tubes when using grayscale ultrasound and in 93% when using B-flow ultrasound; and in the distal part in 81% when using grayscale ultrasound and in 98% when using B-flow ultrasound. When using air and saline, flow was seen in the intramural part of 90% and 93% of the tubes, in the middle part in 54% and 72%, and in the distal part in 66% and 90%, using grayscale ultrasound and B-flow ultrasound, respectively. CONCLUSION B-flow ultrasound facilitates detection of flow of contrast in the middle and distal parts of the tubes at HyCoSy, especially when a mixture of saline and air is used as contrast medium.
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Affiliation(s)
- P Sladkevicius
- Department of Obstetrics and Gynecology, Skåne University Hospital Malmö, Lund University, Malmö, Sweden
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He Y, Geng Q, Liu H, Han X. First experience using 4-dimensional hysterosalpingo-contrast sonography with SonoVue for assessing fallopian tube patency. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:1233-1243. [PMID: 23804346 DOI: 10.7863/ultra.32.7.1233] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study was conducted to describe our first experience using transvaginal 4-dimensional (4D) hysterosalpingo-contrast sonography with SonoVue (Bracco International BV, Amsterdam, the Netherlands) for diagnosis of fallopian tube patency. The study was prospective and conducted in a university hospital setting. The sonographic procedures included 2-dimensional transvaginal sonography for evaluating uterine and ovarian mobility, observing intubation, and determining the initial plane and 4D hysterosalpingo-contrast sonography for observing periovarian and pelvic diffusion. Ninety-six outpatients visiting infertility clinics underwent 4D hysterosalpingo-contrast sonography. All patients finished the examination successfully. A total of 192 fallopian tubes were assessed, of which 95 (49.5%) were classified as type A (the tube was patent, and the contrast agent flowed smoothly through it), 72 (37.5%) as type B (the tube was patent, but the contrast agent did not flow smoothly inside it), and 25 (13.0%) as type C (blocked). Sixteen patients underwent laparoscopy or laparoscopy combined with hysteroscopy; 28 tubes (87.5%) were concordant with laparoscopy. The sensitivity, specificity, positive predictive value, negative predictive value, and Youden index for 4D hysterosalpingo-contrast sonography versus laparoscopy were 81.8%, 90.5%, 81.8%, 90.5%, and 0.72 respectively. In total, 92.7% of patients did not require a hospital stay after 4D hysterosalpingo-contrast sonography, and none need resuscitation. The others stayed in the hospital for clinical observation because of a severe vasovagal reaction or severe pain but received only bed rest without any medical treatment. Forty patients (41.7%) felt slight pain; 39 (40.6%) felt moderate pain; and 15 (15.6%) had a vasovagal reaction. No procedure or postprocedure complications occurred in any patient. In conclusion, 4D hysterosalpingo-contrast sonography with SonoVue is an available screening method for assessment of tubal patency and is tolerable for most patients.
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Affiliation(s)
- Yanni He
- Department of Ultrasonography, Third Affiliated Hospital of Southern Medical University, 183 W Zhongshan Ave, 510630 Guangzhou, Guangdong, China
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ATKIN KL, BALOGUN M. Hysterosalpingography: a resurgent study, 100 years after it was first performed. IMAGING 2013. [DOI: 10.1259/imaging/90763188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Exacoustos C, Di Giovanni A, Szabolcs B, Romeo V, Romanini ME, Luciano D, Zupi E, Arduini D. Automated three-dimensional coded contrast imaging hysterosalpingo-contrast sonography: feasibility in office tubal patency testing. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2013; 41:328-335. [PMID: 22648792 DOI: 10.1002/uog.11200] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/26/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the feasibility of transvaginal hysterosalpingo-contrast sonography (HyCoSy) with new automated three-dimensional coded contrast imaging (3D-CCI) software in the evaluation of tubal patency and visualization of tubal course. METHODS Patients undergoing HyCoSy with automated 3D-CCI software were evaluated prospectively. First, to evaluate the feasibility of 3D visualization of tubal course, we performed consecutive volume acquisitions while injecting SonoVue contrast agent. We then performed conventional two-dimensional (2D) real-time HyCoSy to confirm tubal patency status by detection of saline and air bubbles moving through the Fallopian tubes and around the ovaries. We also evaluated visualization with CCI of the contrast agent around the ovaries, side effects and pain during and after the procedure, by visual analog scale (VAS) (ranging from 0 to 10, with 0 corresponding to no pain and 10 corresponding to maximum pain). RESULTS A total of 126 patients (252 tubes) underwent 3D-CCI HyCoSy followed by 2D real-time HyCoSy. According to the final 2D real-time evaluation, bilateral tubal patency was observed in 111 patients, bilateral tubal occlusion in four patients and unilateral tubal patency in 11 patients. The concordance rate for tubal patency status between the first 3D volume acquisition and the final 2D real-time evaluation was 84% and that between the second 3D volume acquisition and the final 2D real-time evaluation was 97%. A pain score >5 on VAS was recorded in 58% of patients during the procedure, but a pain score ≤ 5 was recorded in 85.7% of patients immediately after the procedure. CONCLUSIONS HyCoSy with automated 3D-CCI technology retains the advantages of conventional 2D HyCoSy while overcoming the disadvantages. 2D HyCoSy is highly observer-dependent and is only accurate in the hands of experienced investigators; by obtaining a volume of the uterus and tubes, automated 3D volume acquisition permits visualization of the tubes in the coronal view and of the tubal course in 3D space, and should allow less experienced operators to evaluate tubal patency status relatively easily.
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Affiliation(s)
- C Exacoustos
- Department of Obstetrics and Gynecology, Università degli Studi di Roma Tor Vergata, Rome, Italy.
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Van Schoubroeck D, Van den Bosch T, Meuleman C, Tomassetti C, D'Hooghe T, Timmerman D. The use of a new gel foam for the evaluation of tubal patency. Gynecol Obstet Invest 2012; 75:152-6. [PMID: 23296258 DOI: 10.1159/000345865] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 11/14/2012] [Indexed: 11/19/2022]
Abstract
AIMS To evaluate the feasibility and the reliability of hysterosalpingo-foam sonography (HyFoSy) using gel foam in the assessment of tubal patency. METHODS Nonrandomized, observational, academic and single-center study of 20 women being investigated because of subfertility and scheduled for a laparoscopy with chromopertubation. A detailed description of HyFoSy with a newly developed gel foam is given in the way it proved to be most efficient in our hands. The results of HyFoSy are compared to the data regarding tubal patency testing during laparoscopy by chromopertubation. RESULTS All 20 HyFoSy were technically successful. Four of the 40 tubes, 1 right tube and 3 left tubes, were not patent at HyFoSy (3 tubes with proximal block and 1 tube with distal block). There was a 100% agreement between tubal patency data according to HyFoSy testing and laparoscopic chromopertubation testing. CONCLUSION HyFoSy is both feasible and accurate in the diagnosis of tubal patency.
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Siam EM. Pregnancy outcome after hystero-salpingo-contrast-sonography (HyCoSy) versus hysterosalpingography (HSG) using different contrast media. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2011. [DOI: 10.1016/j.mefs.2011.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Luciano DE, Exacoustos C, Johns DA, Luciano AA. 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 2011; 204:79.e1-5. [PMID: 21187197 DOI: 10.1016/j.ajog.2010.08.065] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 07/27/2010] [Accepted: 08/20/2010] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of the study was to assess the accuracy of hysterosalpingo-contrast sonography (HyCoSy) in establishing tubal patency or blockage and evaluating the uterine cavity by comparing it with hysteroscopy laparoscopy (HLC) or hysterosalpingography (HSG). STUDY DESIGN This study was a chart review evaluating infertility patients and patients who had undergone hysteroscopic sterilization who underwent both HyCoSy and HLC or HyCoSy and HSG at private offices associated with university hospitals. Sensitivity, specificity, positive predictive value, and negative predictive value of HyCoSy were calculated. RESULTS HyCoSy compared with HLC had a sensitivity of 97% and specificity of 82%, and HyCoSy compared with HSG was 100% concordant. Uterine cavities evaluated by sonohysterography and hysteroscopy were 100% concordant. CONCLUSION HyCoSy is accurate in determining tubal patency and evaluating the uterine cavity, suggesting it could supplant HSG not only as the first-line diagnostic test in an infertility workup but also in confirming tubal blockage after hysteroscopic sterilization.
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Xu HX. Contrast-enhanced ultrasound: The evolving applications. World J Radiol 2009; 1:15-24. [PMID: 21160717 PMCID: PMC2999308 DOI: 10.4329/wjr.v1.i1.15] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 12/17/2009] [Accepted: 12/21/2009] [Indexed: 02/07/2023] Open
Abstract
Contrast-enhanced ultrasound (CEUS) is a major breakthrough for ultrasound imaging in recent years. By using a microbubble contrast agent and contrast-specific imaging software, CEUS is able to depict the micro- and macro-circulation of the targeted organ, which in turn leads to improved performance in diagnosis. Due to the special dual blood supply system in the liver, CEUS is particularly suitable for liver imaging. It is evident that CEUS facilitates improvement for characterization of focal liver lesions (FLLs), detection of liver malignancy, guidance for interventional procedures, and evaluation of treatment response after local therapies. CEUS has been demonstrated to be equal to contrast-enhanced computed tomography or magnetic resonance imaging for the characterization of FLLs. In addition, the applicability of CEUS has expanded to non-liver structures such as gallbladder, bile duct, pancreas, kidney, spleen, breast, thyroid, and prostate. The usefulness of CEUS in these applications is confirmed by extensive literature production. Novel applications include detecting bleeding sites and hematomas in patients with abdominal trauma, guiding percutaneous injection therapy and therefore achieving the goal of using interventional ultrasonography in managing splenic trauma, assessing the activity of Crohn’s disease, and detecting suspected endoleaks after endovascular abdominal aneurysm repair. Contrast-enhanced intraoperative ultrasound (US) and intracavitary use of CEUS have been developed and clinically studied. The potential use of CEUS involves sentinel lymph node detection, drug or gene delivery, and molecular imaging. In conclusion, the advent of CEUS has greatly enhanced the usefulness of US and even changed the status of US in clinical practice. The application of CEUS in the clinic is continuously evolving and it is expected that its use will be expanded further in the future.
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Exacoustos C, Di Giovanni A, Szabolcs B, Binder-Reisinger H, Gabardi C, Arduini D. Automated sonographic tubal patency evaluation with three-dimensional coded contrast imaging (CCI) during hysterosalpingo-contrast sonography (HyCoSy). ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2009; 34:609-612. [PMID: 19852043 DOI: 10.1002/uog.7442] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- C Exacoustos
- Department of Obstetrics and Gynecology, Università degli Studi di Roma, Tor Vergata, Rome, Italy.
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