Abstract
Background: In order to identify the structural causes of infertility in women, imaging is a prevalent health issue that must be treated. For uterine, tubal, and peritoneal variables, the three-dimensional multi-detector computed tomography hysterosalpingography (3D-MDCT-HSG) procedure offers a simple workup. The capabilities of multidetector CT are combined with the well-established method of hysterosalpingography to create the novel, noninvasive modality known as virtual hysterosalpingography, which enables simultaneous, non-invasive evaluation of the entire uterine wall, uterine cavity, cervix, and Fallopian tubes. A key benefit of the operation, which can be used as an alternative diagnostic method in the infertility workup algorithm, is the evaluation of the para-uterine pelvic tissues. With the reconstruction of two-dimensional, three-dimensional, and virtual endoscopic views, virtual hysterosalpingography enables a thorough assessment of the female reproductive system with just one imaging test. It also provides accurate anatomical information and a thorough characterization of the various pathologic processes.
Aim: The aim of the study was to assess the spectrum of uterine, tubal, and peritoneal factors on 3D-MDCT-HSG and determine its diagnostic accuracy for female factor infertility.
Material and Method: The Department of Radiology conducted the study, which was prospective. This study included 25 participants who were infertile. With no HSG contraindications, the women were assessed on days 7 through 10 of their menstrual cycle. Each diagnostic test was interpreted by a different radiologist in a blinded manner with relation to the following: Presence of any lesion causing infertility. The lesion's type and location. Fallopian tube health. After the final diagnosis was made, the radiologist analyzed the MDCT VHSG images and reexamined the X-ray images before creating a reference final result (X- ray). An enhanced reference final result was produced using this procedure.
Results: The sensitivity for uterine pathology, fallopian tube pathology, and per-patient pathology of MDCT VHSG was 100%, yet of X-ray, HSG was 89%, 100%, and 86 tube% respectively. Where specificity for uterine pathology, fallopian tube pathology, and per-patient pathology of MDCT VHSG was 100%, 92%, and 90% respectively, and of X-ray HSG was 92.3%, 85%, and 79% respectively. PPV for uterine pathology, fallopian tube pathology, and per-patient pathology of MDCT VHSG was 100%, 90%, and 92% respectively whereas o -ray HSG was 89%, 84%, and 86% respectively.
Conclusion: Imaging studies play a significant and important part in the diagnostic and therapeutic steps involved in the evaluation of infertile women; VHSG has the capacity to integrate the majority of the benefits of the diagnostic methods, making it a useful tool for the gynecologist in the evaluation and treatment of the infertile woman. Whether it should be used in place of typical conventional HSG entirely in cases of infertility in females, or just as a backup, and when suspicious or abnormal findings are found.
Keywords: Female factor, Hystero-laparoscopy, Hysterosalpingography, Infertility and CT