Fallopian tubal patency diagnosed by magnetic resonance hysterosalpingography.

OBJECTIVE

To discuss the value of magnetic resonance hysterosalpingography (MR HSG) in diagnosing tubal patency of the fallopian tube.

STUDY

DESIGN

Conventional pelvic magnetic resonance imaging (MRI) and MR HSG were performed on 20 infertile women who had all undergone conventional X-ray HSG or laparoscopy within the previous 6 months. Conventional scanning sequences included T2-weighted axial, T2-weighted sagittal, T2-weighted coronal and T1-weighted axial scans. A balloon catheter was placed into the uterine cavity, and then flash 3D coronal scanning by MRI was performed with the uterine injection of a diluted mixture of Gadodiamide (1:100), and data was reconstructed after digital subtraction scan.

RESULTS

Except for a failure caused by a uterine malformation in which the left side of the cervix was not exposed, all patients successfully completed MR HSG inspection. Test results were compared with the previous conventional HSG or laparoscopy inspection results. One patient's results indicated interstitial tubal obstruction on the left side with conventional HSG, but the MR HSG results suggested tubal patency on the same side. A patient with supposed bilateral hydrosalpinx and fallopian tube obstruction under the previous conventional HSG was diagnosed with bilateral hydrosalpinx without obstruction with MR HSG. Another patient with tubal obstruction under conventional X-ray inspection was found to have tubal patency on the right side with MR HSG. The remaining test results in patients were consistent with the previous normal HSG or laparoscopy. Endometrial and pelvic conditions could be well displayed in the course of pelvic MR scan; uterine malformations, uterine fibroids and pelvic conditions such as hydrosalpinx were also well displayed.

CONCLUSION

Routine MRI scan with MR-facilitated HSG can better display the fallopian tubes, ovaries, uterus and pelvic-related structures and therefore has clinical value in the diagnosis of infertility.