What Is a Hysterosalpingography?

Hysterosalpingogram (HSG) refers to the process of injecting a contrast into the uterine cavity, recording the flow of contrast medium through X-ray observation, showing the morphology of the uterus and the fallopian tube cavity, and the dispersion of the contrast agent after it has flowed into the abdominal cavity. Fallopian tube morphology and function make diagnostic measures for infertility diagnosis. HSG is one of the initial tests for female infertility and has indispensable diagnostic value.

Basic Information

English name
hysterosalpingography
Visiting department
Obstetrics and Gynecology
Multiple groups
female
Common locations
Uterus, fallopian tubes

Hysterosalpingography

HSG was the first to use a higher concentration of lipiodol as a contrast agent, which is characterized by a thick and slow flow rate, and the contours of the uterine cavity and the fallopian tube folds are delicate and clear. Also because of the slow absorption, a plain film of the pelvic cavity can be taken after 24 hours, which can well observe the dispersion and absorption of the contrast agent, and improve the accuracy of the doctor's diagnosis of pelvic adhesions. At the same time, it also has a certain therapeutic effect. The pregnancy rate in a short time after angiography is higher than that of dimeglumine. The disadvantage is the danger of stimulating the formation of granulomas in the peritoneum, which is difficult to absorb even after many years. More than a decade ago, lipiodol was basically eliminated as a contrast agent.
Followed by water-based dimeglumine glucosamine, its viscosity is reduced, its absorption rate is fast, and the clarity of the diagnosis is slightly reduced, and it is impossible to take pictures after 24 hours. The above two contrast agents need to be tested for iodine allergy, and those who are allergic to iodine are forbidden to use it. With the advent of non-ionic iodine contrast agents such as iopromide, there was no need for iodine allergy experiments, and the last threshold of HSG was removed.

Clinical significance of hysterosalpingogram

HSG can display the shape of the uterine cavity. The degree of pressure generated when the contrast medium is injected can be estimated according to the degree of uterine swelling, so that the resistance of the fallopian tube can be judged. The adhesion, uterine can be judged based on whether the edges are rough and the filling defect and the presence of shadows Presence of cavity polyps and submucosal uterine fibroids; abnormal uterine morphology can easily provide information on the bicornuate uterus, mediastinum, and T-shaped uterus. The diagnosis of tubal obstruction is less controversial, as stagnant contrast agents are often seen. It is difficult to judge whether it is between "pass" and "chang". The full development of the fallopian tube is "pass". "Pass" is the premise. It must also be "open". The ability of the fallopian tube to pick up eggs and transport sperm and embryos is Built on unblocked. Fertilized eggs must reach the uterus from the end of the fourth day to the beginning of the fifth day after ovulation. After this time, ectopic pregnancy may occur. Therefore, the shape of a good fallopian tube should stretch like a flowing cloud sleeve, and the diffuse contrast agent should "float" in the pelvic cavity like a faint cloud. Tortuous coiling, segment expansion, stiffness, beading, sharp transitions, spray-like spillage of contrast medium, and dispersal into clumps are all visions that require attention and careful analysis. The fallopian tube umbrella is raised, as long as the shape is soft and natural, it is not abnormal. Because this situation is mostly caused by the contrast medium flow stimulus up. The outer third of the fallopian tube is free and can be moved, and the umbrella end has a strap that is tightly connected to the ovary and can swing back and forth. Reading HSG films requires a lot of experience, and it must be closely integrated with the clinic. Occasionally, HSG readings can be seen clinically to show that patients with poor pregnancy are pregnant, so patients should be given sufficient encouragement and appropriate guidance.
The accurate reading of HSG determines the decision-making direction of infertility. With the application of DSA technology in the field of HSG, a digital dynamic HSG has begun to be widely used in clinical practice, which overcomes many disadvantages of conventional HSG, provides dynamic image information, and reduces contrast agents. The cover-up effect makes the diagnosis more accurate and brings the gospel to the majority of infertility patients.

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