Piccotti K, Guida D, Carbonetti F, Stefanetti L, Macioce A, Cremona A, David V
Dipartimento di Diagnostica per Immagini, Ospedale Sant'Andrea. Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", Roma, Italia.
Clin Ter. 2015;166(2):e91-7. doi: 10.7417/CT.2015.1826.
Comparison of diagnostic quality in hysterosalpingography between low and high-osmolality contrast media.
We performed a retrospective evaluation of two cohorts of patients who underwent HSG using contrast media with different osmolarity: the first group ,47 patients, underwent hysterosalpingography in the period September 2011-December 2012 using Iopromide 370 mg/ml; the second group, 50 patients, underwent HSG from January 2013 to October 2013 using Iomeprol 400 mg/ml. Three radiologists, in consensus reading,, reviewed the radiographs by assessing the following four parameters: opacification of the uterine cavity, uterine profiles definition, Fallopian tubes visualization, contrast media spillage into peritoneum. A score-scale from 0 to 3 was assigned for each of the mentioned parameter (0 = minimum non-diagnostic exam, 1 = sufficient examination; 2 = good quality examination; maximum 3 = high quality images).
We documented a statistically significant higher quality in displaying Fallopian tubes among patients studied through high osmolarity contrast medium (Iopromide 370 mg/ml) than what obtained through lower osmolarity contrast medium (Iomeprol 400 mg/ml).
The use of high osmolarity contrast medium enabled better visualization of the tubes and a greater number of diagnoses of chronic aspecific salpigintis due to the increased osmolality and viscosity of Iomeprol 400 mg/ml. There were no significant differences between the two contrast agents in the evaluation of intra-uterine pathology and in the evaluation of the tubal patency.
比较低渗和高渗造影剂在子宫输卵管造影中的诊断质量。
我们对两组使用不同渗透压造影剂进行子宫输卵管造影(HSG)的患者进行了回顾性评估:第一组47例患者,于2011年9月至2012年12月期间使用碘普罗胺370mg/ml进行子宫输卵管造影;第二组50例患者,于2013年1月至2013年10月期间使用碘美普尔400mg/ml进行HSG。三位放射科医生通过评估以下四个参数进行一致性阅片:子宫腔显影、子宫轮廓清晰度、输卵管显影、造影剂向腹腔内溢出。对每个上述参数赋予0至3分的评分(0 = 最低非诊断性检查,1 = 充分检查;2 = 高质量检查;最高3 = 高质量图像)。
我们记录到,与使用低渗造影剂(碘美普尔400mg/ml)的患者相比,使用高渗造影剂(碘普罗胺370mg/ml)的患者在显示输卵管方面具有统计学上显著更高的质量。
由于碘美普尔400mg/ml的渗透压和粘度增加,使用高渗造影剂能够更好地显示输卵管,并能对更多慢性非特异性输卵管炎进行诊断。在评估子宫内病变和输卵管通畅性方面,两种造影剂之间没有显著差异。