HYSTEROSALPINGOGRAPHY WITH VIDEOFLUOROSCOPY - EFFECT ON RADIOLOGIC PRACTICE IN AN ACADEMIC-MEDICAL-CENTER

Rationale and Objectives. The authors attempted to determine whether v ideotaping the fluoroscopic portion of hysterosalpingography would res ult in changed diagnosis or an increase in diagnostic confidence. Mate rials and Methods. Ninety-nine consecutive outpatients underwent routi ne hysterosalpingography. The fluoroscopic portion of the examination was captured on videotape. Two consecutive interpretations of each hys terosalpingogram were made by attending radiologists. First, spot radi ographs were interpreted alone. Second, these images were viewed along with videofluoroscopy. Concordance of and confidence in findings for the two interpretations were assessed with the two-tailed Fisher exact test. Results. Interpretations of spot radiographs alone and with vid eofluoroscopy were in agreement in 92 of 99 uterine examinations and 1 64 of 198 tubal examinations. For uterine examinations classified as n ormal, interpretations of spot radiographs and videofluoroscopic were in agreement in 56 of 57 cases; there was no change in confidence with review of videofluoroscopic images. For uterine examinations, interpr eted as abnormal, agreement was noted in 36 of 42 cases (P = .04), and confidence increased with videofluoroscopy in 10 of 42 cases (P = 0.0 001). With normal tubal findings, interpretations agreed in 94 of 80 c ases (P = .002) . sWhen findings with and without videofluoroscopy wer e discordant, confidence was always higher after review of videofluoro scopic images. Conclusion. Review of videofluoroscopic images obtained during hysterosalpingography increases the accuracy and confidence of diagnosis compared with review of spot radiographs alone.