Yoder I C, Hall D A
Department of Radiology, Massachusetts General Hospital, Boston 02114.
AJR Am J Roentgenol. 1991 Oct;157(4):675-83. doi: 10.2214/ajr.157.4.1892018.
All physicians involved in the evaluation and treatment of infertility rely heavily on the information provided by hysterosalpingography. For many years this study has provided images of the lumina of the fallopian tubes that are not available by other diagnostic means, and it also gives the most accurate outline of the uterine cavity. Hysterosalpingography will therefore continue to be a valuable study in the upcoming decade, and it is important now to take account of the many advances in technology that impinge on the execution and interpretation of this study. In this article we first update the continuing debate about elements of the study itself, involving techniques and the choice of contrast material. We also consider surgical advances, such as the widespread use of microsurgical reconstruction of the fallopian tube, that increase the demand for hysterosalpingography. Since radiologists are asked to evaluate the results of surgery, it is essential for them to be familiar with the postoperative appearances of the fallopian tube. Finally, we consider what must be by far the most important development of the 1990s, the continuing integration of hysterosalpingography with new interventional and imaging techniques. Fallopian tube catheterization expands the examination of the fallopian tube and offers new therapeutic applications. Transvaginal sonography and MR imaging have allowed noninvasive exploration of the female pelvis. Correlation of hysterosalpingography and MR imaging is particularly useful in the diagnosis of uterine myomas and congenital uterine duplication anomalies when surgery to preserve or enhance the reproductive capacity of the uterus is indicated. Sonography and MR imaging should be correlated with hysterosalpingography to provide a more efficient diagnostic and therapeutic approach to the common mechanical causes of infertility.
所有参与不孕症评估和治疗的医生都严重依赖子宫输卵管造影所提供的信息。多年来，这项检查提供了通过其他诊断方法无法获得的输卵管管腔图像，并且还能给出最准确的子宫腔轮廓。因此，子宫输卵管造影在未来十年仍将是一项有价值的检查，现在重要的是要考虑到影响这项检查实施和解读的诸多技术进步。在本文中，我们首先更新关于该检查本身要素的持续争论，包括技术和造影剂的选择。我们还会考虑外科手术的进展，比如输卵管显微外科重建的广泛应用，这增加了对子宫输卵管造影的需求。由于放射科医生需要评估手术结果，他们熟悉输卵管术后表现至关重要。最后，我们考虑20世纪90年代至今最重要的发展，即子宫输卵管造影与新的介入和成像技术的持续整合。输卵管插管扩展了对输卵管的检查并提供了新的治疗应用。经阴道超声检查和磁共振成像能够对女性盆腔进行无创探查。当需要进行保留或增强子宫生殖能力的手术时，子宫输卵管造影与磁共振成像的联合在诊断子宫肌瘤和先天性子宫重复畸形方面特别有用。超声检查和磁共振成像应与子宫输卵管造影相结合，以便为常见的机械性不孕原因提供更有效的诊断和治疗方法。
