Thijssen Soetkin G, G Heremans Ruben R, Nderlita Meri, Froyman Wouter J G, Housmans Susanne, Poppe Willy A J, Timmerman Dirk, den Bosch Thierry Van
Department of Obstetrics and Gynaecology, University Hospitals KU Leuven, Leuven, Belgium.
Department of Obstetrics and Gynaecology, RZ Tienen, Tienen, Belgium.
J Med Ultrasound. 2019 Sep 6;28(1):35-40. doi: 10.4103/JMU.JMU_29_19. eCollection 2020 Jan-Mar.
Possible transtubal spillage of malignant cells is a major concern in fluid instillation sonography, as it is in hysteroscopy. This study aims to compare the transtubal flow of gel and saline and validate the clinical hypothesis that application of fluids with higher viscosity causes less spillage.
Randomized controlled trial comparing gel and saline infusion on 15 tissue specimens after hysterectomy with bilateral salpingectomy. Instillations are performed with saline and gel dyed with a 1% ink solution. Qualitative assessment of tubal spill is investigated as primary outcome. Secondary outcomes are instillation-volume and -pressure, assessed by measuring endometrial cavity dilation at ultrasound examination and subjective numeric 10-point scoring of the instillation pressure by a dedicated examiner.
Tubal flow was more often observed during saline instillation (odds ratio 4.88, = 0.008). Median subjectively assessed instillation pressures were nine arbitrary units for gel and three for saline ( < 0.001). Tubal flow occurred from 2 cc onward in the saline group versus five cc in the gel instillation group. Cavitary dilation did not differ between both groups.
Gel instillation sonography is associated with less tubal flow and therefore could be a safer diagnostic test compared to saline infusion sonography or hysteroscopy. studies are necessary to confirm these results.
与宫腔镜检查一样，恶性细胞经输卵管溢出是液体灌注超声检查中的一个主要问题。本研究旨在比较凝胶和生理盐水的经输卵管流动情况，并验证临床假设，即应用较高粘度的液体可减少溢出。
对15例子宫切除术后双侧输卵管切除的组织标本进行凝胶和生理盐水灌注的随机对照试验。用生理盐水和含1%墨水溶液的凝胶进行灌注。将输卵管溢出的定性评估作为主要结果。次要结果是灌注量和压力，通过超声检查测量子宫内膜腔扩张情况以及由专门检查者对灌注压力进行主观数字10分评分来评估。
生理盐水灌注时更常观察到输卵管流动（优势比4.88，P = 0.008）。凝胶灌注的主观评估灌注压力中位数为9个任意单位，生理盐水灌注为3个任意单位（P < 0.001）。生理盐水组从2毫升开始出现输卵管流动，而凝胶灌注组为5毫升。两组的宫腔扩张情况无差异。
凝胶灌注超声检查与较少的输卵管流动相关，因此与生理盐水灌注超声检查或宫腔镜检查相比可能是一种更安全的诊断测试。需要进一步研究来证实这些结果。
