Three-dimensional power Doppler imaging in the assessment of Fallopian tube patency

Objective The aim of the study was to evaluate the feasibility of three-dim ensional power Doppler imaging (3D-PDI) in the assessment of the patency of the Fallopian tubes during hysterosalpingo-contrast sonography (HyCoSy). Methods Women attending the fertility clinic were offered a Fallopian tubal patency test as part of the initial investigation. Hysterosalpingo-contras t sonography using contrast medium Echovist was performed on 67 women. Find ings on the two-dimensional (2D) gray-scale scanning and three-dimensional power Doppler imaging were compared The first technique visualizes positive contrast in the Fallopian tube; the second demonstrates flow of medium thr ough the tube. Results Contrast medium Echovist produced prominent signals on the 3D-PDI i mage. Free spill from the fimbrial end of the Fallopian tubes was demonstra ted in 114 (91 %) tubes using the 3D-PDI technique and in 58 (46 %) of tube s using conventional HyCoSy. The mean duration of the imaging procedure was less with 3D-PDI, but the operator time which included postprocedure analy sis of the stored information was similar: A significantly lower volume of contrast medium (5.9 +/- 0.6 mL) was used for 3D-PDI in comparison with tha t (11.2 +/- 1.9 mL) used for conventional 2D HyCoSy. Conclusion Color coded 3D-PDI with surface rendering allowed visualization of the flow of contrast through the entire tubal length and F-ee spill of c ontrast was clearly identified in the majority of cases. The 3D-PDI method appeared to have advantages over the conventional HyCoSy technique especial ly in terms of visualization of spill fi-om the distal end of the tube, whi ch was achieved twice as often with the 3D technique. Although the design o f the investigation did not allow the side effects of the two techniques to be compared, the shorter duration of the imaging and lower volume of the c ontrast medium used suggested that the 3D-PDI technique might have a better side-effect profile. The 3D-PDI technique allowed better storage of the in formation for re-analysis and archiving than conventional HyCoSy.