COMBINING B-MODE ULTRASOUND WITH PULSED WAVE DOPPLER FOR THE ASSESSMENT OF TUBAL PATENCY

This study was conducted to determine whether the additional use of pu lsed wave Doppler improves the diaggnostic capacity in assessing tubal patency by hysterosalpingo contrast sonography (HyCoSy). A total of 2 10 women with a history of infertility were included in this study. Hy CoSy was performed after intrauterine injection of Echovist(R) 200. Fo r the assessment of tubal patency B-mode scanning and pulsed wave Dopp ler ultrasound were performed in the proximal and distal tubal segment s. With the combined sonographic procedure 297 tubes (74%) were rated patent, 35 (8%) incompletely obstructed and 70 (18%) completely obstru cted. A total of 252 tubes were additionally examined by laparoscopy f or reference purposes. Concordant results for both methods were found in 92% of tubes, nine had been rated false negative and 10 tubes appea red to have been rated false positive. The combined sonographic specif icity was found to be 85% with a sensitivity of 95%. Peritubal adhesio ns detected by laparoscopy were found to be the reason for false posit ive sonographic results in 60% of cases. In conclusion, the combined B -mode and pulsed wave Doppler examination appears to be a non-invasive and low-cost test for the assessment of tubal patency, which should b e performed during diagnostic work-up for infertility.