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

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.