Hysterosalpingo contrast sonography (HyCoSy) with SH U 454 (Echovist) for the assessment of tubal patency

A total of 88 Fallopian tubes from 44 patients was examined withhysterosalpingo contrast sonography (HyCoSy), hysterosalpingogram (HSG),and laparoscopic chromopertubation (LC) in order to assess their relativeaccuracy for measuring tubal patency. HyCoSy was done by transvaginalultrasound and the contrast was SH U 454 (Echovist). The flow of multiplefractions of the contrast medium through each Fallopian tube was observedin real time in appropriate imaging planes by means of a transvaginalprobe. Compared with laparoscopic results, we found a sensitivity of 85.2%,a specificity of 85.2%, a positive predictive value (PPV) of 71.9%, anegative predictive value (NPV) of 92.9% and concordance (HyCoSy/LC) of85.2%, while the corresponding values for HSG were sensitivity = 85.2%,specificity = 83.6%, PPV = 69.7%, NPV = 92.7% and concordance (HSG/LC) of84.1%. Compared with HSG results, HyCoSy obtained a co-positivity of 66.7%,a co-negativity of 81.8% and a concordance of 76.1%. In conclusion, HyCoSywith SH U 454 proved to be a reliable and safe modality for evaluatingtubal patency; it is suitable as an outpatient diagnostic procedure to beused before more invasive procedures.