The sonographic evaluation of tubal patency with stimulated acoustic emission imaging

Objectives Experimental and clinical data suggest that insonation of echo‐enhancing contrast agents with high acoustic power produces disintegration of microbubbles, resulting in a phenomenon called stimulated acoustic emission (SAE). The purpose of this study was to investigate whether SAE might be...

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Published in:Ultrasound in obstetrics & gynecology 2002-10, Vol.20 (4), p.386-389
Main Authors: Prefumo, F., Serafini, G., Martinoli, C., Gandolfo, N., Gandolfo, N. G., Derchi, L. E.
Format: Article
Language:English
Subjects:
Acoustics
Adult
Biological and medical sciences
Birth control
Contrast Media
Contrast medium
Fallopian Tube Patency Tests - methods
Fallopian Tubes - diagnostic imaging
Female
Gynecology. Andrology. Obstetrics
Humans
Hysterosalpingography - methods
Infertility, Female - diagnosis
Medical sciences
Polysaccharides
Prospective Studies
Sterility. Assisted procreation
Stimulated acoustic emission
Transvaginal ultrasound
Tubal patency
Ultrasonography
Uterus - diagnostic imaging
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Summary:Objectives Experimental and clinical data suggest that insonation of echo‐enhancing contrast agents with high acoustic power produces disintegration of microbubbles, resulting in a phenomenon called stimulated acoustic emission (SAE). The purpose of this study was to investigate whether SAE might be detected by transvaginal sonography and whether this technique may be useful in the assessment of tubal patency by hysterosalpingo‐contrast sonography (SAE‐HyCoSy). Methods Patients booked for X‐ray hysterosalpingography (HSG) for infertility evaluation also received SAE‐HyCoSy. The order of the two procedures was established in each patient by randomization after placement of a transcervical balloon catheter. For SAE‐HyCoSy, the ultrasound contrast medium Levovist was injected, with the acoustic power set at the maximum level permitted on ultrasound machines employing dedicated algorithms. Conventional HSG was performed for comparison. Results Seventy‐seven Fallopian tubes were examined in 41 patients. In all cases it was possible to obtain the SAE phenomenon. In 10 tubes (13%) proximal filling was not observed by both SAE‐HyCoSy and HSG. In the remaining 67 tubes, free spill from the distal end of the lumen was demonstrated in 96% of cases (64/67) with SAE‐HyCoSy and in 97% of cases (65/67) with HSG. Disagreement between the two techniques was observed in five tubes only, with a Cohen's κ coefficient of 0.76 (95% confidence interval, 0.56–0.96). Conclusion SAE techniques were successfully applied to HyCoSy and allowed the visualization of the free spill of contrast agent into the peritoneal cavity in the majority of cases. SAE‐HyCoSy showed good agreement with HSG in this preliminary study. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
ISSN:0960-7692
1469-0705
DOI:10.1046/j.1469-0705.2002.00823.x