The role of multidetector CT virtual hysterosalpingography in the evaluation of female infertility

PurposeTo assess the role of 64-row multidetector computed tomography virtual hysterosalpingography (MDCT VHSG) in the evaluation of the female reproductive tract in infertile patients and compare it with conventional X-ray hysterosalpingography (HSG).Methods and materialThe studied group included 25 patients with infertility. All patients were evaluated with 64-row MDCT VHSG and X-ray HSG. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of both examinations for uterine pathology, fallopian tube pathology and per lesion pathology were calculated. The duration for both examinations, patient discomfort and patient effective dose were documented.ResultsThe mean duration for MDCT VHSG and X-ray HSG was 6.5 ± 1.9 and 26.9 ± 2.9 min respectively, MDCT VHSG has a significantly less median patient discomfort and mean patient effective dose. Sensitivity, specificity, PPV and NPV for uterine pathology were 100%, 100%, 100% and 100% respectively for MDCT VHSG and 90%, 93.3%, 90% and 93.3% respectively for X-ray HSG, the inter-method agreement for uterine pathology was k = 0.83. Sensitivity, specificity, PPV and NPV for the detection of fallopian tube pathology were 100%, 93%, 91 and 100% respectively for MDCT VHSG and 100%, 86%, 85% and 100% respectively for X-ray HSG and k = 0.76. Sensitivity, specificity, PPV and NPV for per patient pathology were 100%, 91%, 93% and 100% respectively for MDCT VHSG and 87%, 80%, 87% and 80% respectively for X-ray HSG and k = 0.75.ConclusionMDCT VHSG could be an excellent new alternative diagnostic procedure in the infertility assessment workup.