Hysterosalpingo-contrast sonography of the uterus and fallopian tubes: results of a clinical trial of a new contrast medium in 120 patients

Article Abstract:

Female infertility is often caused by blockage in the fallopian tubes. Imaging procedures can be used to examine the anatomy of the fallopian tubes and the uterus for defects that might cause infertility. The commonly used imaging procedures involve X-rays, but advances in ultrasound have made it a viable option. The main problem encountered with ultrasound imaging has been finding a suitable contrast agent that clearly defines the anatomy of the uterus. A proper agent must also be able to detect information for Doppler (flow) measurements and it must be well tolerated. This study examined the use of a newly developed ultrasound technique using a new contrast agent. The technique is known as hysterosalpingo-contrast sonography (HyCoSy). Subjects were 120 women with sterility problems. They were examined using HyCoSy and more conventional imaging techniques. The results showed that HyCoSy findings of unobstructed tubes were all confirmed by conventional techniques. However, HyCoSy findings of obstructed tubes were only confirmed in half the cases by conventional techniques. Similar results were found in the Doppler measurements. HyCoSy was extremely effective in showing flow in tubes that were unobstructed as determined by conventional techniques. However, it did show some false positive results. A major advantage of HyCoSY is its ability to image tubes separately. It is quick and easy and requires no radiation exposure. Its present diagnostic value is in screening out patients with normal, unobstructed tubes, thus preventing the use of more invasive techniques. At the present time, it cannot be used to accurately diagnose obstructed tubes. Future advances may alter this limitation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diseases, Infertility, Female, Female infertility, Reproductive organs, Female, Female genitalia, Fallopian tubes, Imaging

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Cholecystokinin sonography: lack of utility in diagnosis of acute acalculous cholecystitis

Article Abstract:

Modern imaging techniques such as ultrasonography (US) are highly useful in diagnosing gallbladder diseases. Acute acalculous cholecystitis is an inflammation of the gallbladder that is not associated with the formation of gallstones. It is one gallbladder disease that is hard to diagnose, which is unfortunate because it is also associated with high mortality. A recent study reported that US could be used to diagnose this disease by first injecting a derivative of cholecystokinin, a hormone that stimulates the gallbladder to contract, and using US to confirm whether contraction does not occur because of the presence of disease. That study did not use control subjects who did not have gallbladder disease, however, so this study examined this diagnostic technique using such controls. US of the gallbladder was performed every five minutes for sixty minutes in 15 subjects. These 15 subjects were fasting hospital patients who had no evidence of gallbladder disease. The patients were given a continuous intravenous infusion of sincalide, a derivative of cholecystokinin, during the 60-minute period. No gallbladder contractions occurred in 4 of the 15 subjects. In the other 11 subjects, gallbladder volumes decreased an average of 46 percent, with a range from 15 to 97 percent. No gallbladder problems were found in follow-up of the subjects. The results revealed that gallbladder response to cholecystokinin administration as imaged by US was highly variable, from no contraction to significant contraction. This imaging technique does not appear to be useful in detecting acute acalculous cholecystitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Gallbladder

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Acalculous cholecystitis: a case report

Article Abstract:

It may be advisable to consider acalculous cholecystitis a possible source of repeated upper right abdominal pain. The medical findings on a 19-year-old female patient with a one-year intermittent history of upper right abdominal pain are presented. The patient's gallbladder appeared normal on ultrasound scans but a dye test revealed evidence of an inflamed gallbladder with no gallstones. The patient's gallbladder was removed surgically and tissue tests confirmed that the patient had acalculous cholecystitis.

Case studies, Causes of, Abdominal pain

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