PubMed · 12524106
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Paul G McDonough. 2003. Decision-making when science is ambiguous.. https://doi.org/10.1016/s0015-0282(02)04229-2
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Diagnosis of fallopian tube pathology has been performed with X-rays, ultrasound, magnetic resonance imaging, and even nuclear medicine exams. However, fallopian tube interventions are almost exclusively the domain of fluoroscopy. Fallopian tube interventions can be divided into two categories: embolization and recanalization. The former has only recently been described using imaging guidance while the latter has been accepted as a safe and effective procedure since the early 1990s. This article will highlight the technique and results associated with fallopian tube embolization.
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OBJECTIVE: To assess the role of hysterosalpingoscintigraphy (HSSG) in the evaluation of fallopian tube patency and function and compare the results with hysterosalpingography (HSG) and laparoscopy (LS). DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: The study was conducted at Multan Institute of Nuclear Medicine and Radiotherapy (MINAR), Multan from August 2004 to February 2005. PATIENTS AND METHODS: HSSG was performed after instillation of 4mCi (148 MBq) 99mTechnetium-macroaggregated albumin (99mTc-MAA) in posterior vaginal fornix in 65 patients. Serial static images were acquired in supine position at 1 hour, 2 hours, 3 hours and, if needed, at 24 hours. The results were compared to the findings on LS and HSG. RESULTS: Out of 65 patients, 37 (56.9%) patients had bilateral blocked tubes, 17 (26.1%) patients had bilateral patent tubes, 6 (9.2%) patients had blocked left tube and 5 (7.1%) patients had blocked right tube. The calculated sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV) and accuracy for HSSG were 90%, 83%, 90% and 90% respectively. The agreement between HSSG and LS was found in 32 out of 35 patients and agreement between HSG and HSSG was found in 24 out of 30 patients. CONCLUSION: This simple procedure can delineate tubal physiology; in selected cases it can replace HSG and in others augment the information gathered by HSG. HSSG should be part of the infertility workup algorithm.