Transvaginal hysterosalpingo-contrast sonography for the assessment of tubal patency with gray scale imaging and additional use of pulsed wave Doppler.

OBJECTIVE

To determine whether the additional use of pulsed wave (PW) Doppler can improve the tubal diagnosis reached with gray scale imaging in doubtful cases.

DESIGN

The study is an open, uncontrolled clinical trial of women of childbearing age.

SETTING

Clinical environment.

PATIENTS: Seventeen female patients (23 to 37 years of age) with diagnosed sterility problems.

INTERVENTIONS: The contrast agent SH U 454 was administered transcervically during transvaginal gray scale and PW Doppler sonography.

MAIN OUTCOME MEASURES: Hysterosalpingo-contrast sonography by gray scale and by PW Doppler and follow-up chromolaparoscopy (n = 16) or hysterosalpingography (HSG, n = 1) were performed. The diagnostic efficacy of gray scale and PW Doppler were compared with each other and against a conventional control procedure (chromolaparoscopy or HSG).

RESULTS

The gray scale findings were confirmed by PW Doppler in 5 cases on one side; confirmed by PW Doppler in 7 cases on both sides; corrected by PW Doppler in 4 cases on one side; and corrected by PW Doppler in 1 case on one side and confirmed on the other side by PW Doppler. In all 17 cases, the tubal findings after PW Doppler were confirmed by chromolaparoscopy or HSG.

CONCLUSION

The additional use of PW Doppler in hysterosalpingo-contrast sonography is recommended as a supplement to gray scale imaging (1) in cases of suspected tubal occlusion and (2) in the event of intratubal flow demonstrable only over a short distance.