3D MR vs conventional X-ray hysterosalpingography in the evaluation of female infertility

Purpose: Aim of this work was to compare the new 3D MR-histerosalpingography with the X-ray conventional one in the evaluation of female infertility. Method and materials: 15 infertile female patients (aging 29 - 43 years, mean 35) were studied with a 1.5 T magnet unit (GE Horizon 8.5) using a T2 weighted FSE sequences on axial and coronal plane and a 3D Fast SPGR sequence (3D MRA sequence) on coronal plane after injection of a diluted gadolinium solution into the uterine cavity via a balloon catheter. All the data were compared with conventional X-ray hysterosalpingography. Results: The tomographic images provided a complete evaluation of the uterus and ovaries. The 3D MR technique provided the evidence of the uterine cavity and the patency of the Fallopian tube with a complete concordance with X ray histerosalpingography. However the accuracy in detecting the Fallopian tube calibre was considered inferior with MRI than X-ray by two expert radiologists. Two Fallopian tube stenosis were missed at 3D MR-histerosalpingography. Conclusion: 3D MR histerosalpingography may represent a real promising technique in the non-invasive evaluation of the infertile female. The main advantage is related to the lack of ionising radiation in these young females. Up to date, in our experience, the MR technique does not have the same accuracy as X-ray in detecting the Fallopian tube. Improvement in spatial resolution probably have to be considered.