Comparison between multidetector computed tomography and hysterosalpingography in assessment of infertile couples

Mohamed M. Shaaban, Ismail M. Awwad, Mohamed M. Al Beblawy, Tarek H. Khalil
In: Middle East Fertility Society Journal · 2013 · vol. 18(3) , pp. 191–195 · doi:10.1016/j.mefs.2013.01.013 · W2032385120
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Multidetector CT showed comparable diagnostic accuracy to hysterosalpingography for tubal blockage in infertile couples, with less discomfort and radiation, but was less effective for pelvic adhesions.

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Abstract

To compare the efficacy of multidetector CT (MDCT) with conventional X-ray hysterosalpingography (HSG) in the evaluation of infertile couples. Thirty-four patients with diagnosis of infertility, were evaluated with 4-row MDCT prior to HSG. All patients underwent diagnostic laparoscopy in the following period. Sensitivity, specificity, negative predictive value and positive predictive value of MDCT and HSG for the detection of tubal obstruction and pelvic adhesions were calculated. Mean duration of the procedure for HSG and MDCT respectively was 26 ± 3.3 and 7 ± 1.1 min. MDCT has shown significantly less patient discomfort and mean effective dose of radiation. MDCT was able to diagnose a case of adenomyosis and a case of ovarian tumor further to HSG. HSG diagnosed two cases of unilateral tubal block, four cases of bilateral tubal block and six cases were suggested as pelvic adhesions due to abnormal smearing at the second film. MDCT diagnosed one case of unilateral tubal block, four cases of bilateral tubal block being unable to detect pelvic adhesions because of lack of delayed imaging. Using laparoscopy as a reference standard; sensitivity, specificity, positive predictive value and negative predictive value of MDCT and HSG in detecting tubal block were as follows: (100%, 96.7%, 83.3% and 100% for MDCT in comparison to 100%, 93.7%, 66.7% and 100% for HSG. Sensitivity, specificity, positive predictive value and negative predictive value of HSG in detecting pelvic adhesions were 42.8%, 88.8%, 50%, and 85.7. This study demonstrated the feasibility of evaluating the female reproductive system by MDCT.

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