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-dimensional 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-contrast sonography using contrast medium Echovist was performed on 67 women. Findings 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 through the tube. Results Contrast medium Echovist produced prominent signals on the 3D-PDI image. Free spill from the fimbrial end of the Fallopian tubes was demonstrated in 114 (91 %) tubes using the 3D-PDI technique and in 58 (46 %) of tubes using conventional HyCoSy. The mean duration of the imaging procedure was less with 3D-PDI, but the operator time which included postprocedure analysis 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 that (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 contrast was clearly identified in the majority of cases. The 3D-PDI method appeared to have advantages over the conventional HyCoSy technique especially in terms of visualization of spill fi-om the distal end of the tube, which was achieved twice as often with the 3D technique. Although the design of 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 contrast medium used suggested that the 3D-PDI technique might have a better side-effect profile. The 3D-PDI technique allowed better storage of the information for re-analysis and archiving than conventional HyCoSy.