Hysterosalpingography in endometriosis: performance and interpretation

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This paper reviews the technique, findings, reporting, and potential pitfalls of hysterosalpingography in infertile patients, specifically focusing on its role in evaluating endometriosis.

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This paper discusses how hysterosalpingography (HSG), an imaging exam routinely used in infertility evaluations, can be applied to patients with endometriosis, with attention to technique, patient preparation, and risks/complications, followed by an account of characteristic imaging findings and a suggested reporting template. It illustrates endometriosis-related HSG appearances and describes common interpretation pitfalls, including examples to support accurate reading. A stated limitation is that the article functions as a practical performance/interpretation discussion rather than providing new comparative diagnostic accuracy data. This paper is centrally about endometriosis — it focuses on the performance and interpretation of hysterosalpingography for evaluating endometriosis in infertility.

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Abstract

Endometriosis is often seen and sometimes initially diagnosed on hysterosalpingography (HSG), an imaging exam routinely performed on patients with infertility. Here we discuss the role of HSG in the evaluation of patients with infertility with a focus on patients with endometriosis. The HSG technique, including patient preparation as well as potential risks and complications, is detailed. Imaging findings in patients with endometriosis are illustrated and a template for exam reporting is presented. Common imaging pitfalls are described with examples.
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Abstract

Endometriosis is often seen and sometimes initially diagnosed on hysterosalpingography (HSG), an imaging exam routinely performed on patients with infertility. Here we discuss the role of HSG in the evaluation of patients with infertility with a focus on patients with endometriosis. The HSG technique, including patient preparation as well as potential risks and complications, is detailed. Imaging findings in patients with endometriosis are illustrated and a template for exam reporting is presented. Common imaging pitfalls are described with examples. Similar content being viewed by others

References

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Acknowledgements

Aoife Kilcoyne would like to acknowledge the contribution of the MacErlaine Research Scholarship from the Academic Radiology Research Trust, St. Vincents Radiology Group, Dublin, Ireland, and the Higher Degree Bursary, from the Faculty of Radiologists, RCSI, Ireland. Aileen O’Shea would like to acknowledge the contribution of the MGH-MacErlaine Research Scholarship from the Faculty of Radiologists, RCSI, Ireland, and Massachusetts General Hospital. The authors would like to thank Susanne Loomis for her assistance in preparing the figures. Author information Authors and Affiliations Corresponding author Ethics declarations Disclosures Aoife Kilcoyne and Susanna I Lee are authors for UpToDate, Wolters Kluwer, on Hysterosalpingography. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Electronic supplementary material Below is the link to the electronic supplementary material. Rights and permissions About this article Cite this article Kilcoyne, A., O’Shea, A., Gervais, D.A. et al. Hysterosalpingography in endometriosis: performance and interpretation. Abdom Radiol 45, 1680–1693 (2020). https://doi.org/10.1007/s00261-019-02373-w Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00261-019-02373-w

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Fallopian Tube Diseases Infertility, Female Infertility, Female Female Humans Hysterosalpingography

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