الفهرس 
Anatomy of Female Genital TractOnly 14 pages are availabe for public view
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Abstract
Summary and Conclusion
With the rapid growth in the infertility services, there is a demand for parallel growth in the female infertility imaging.
Although ultrasound, hysterosonography and magnetic resonance imaging are used to assess the female reproductive tract, yet the X-ray hysterosalpingography is still the main and first examination used to evaluate the infertile female with the advantage of assessing the fallopian tube in addition to evaluate the uterus.
The rapid growth in the multi-detector computed tomography technology permits volumetric data acquisition which enabled isotropic imaging quality with high spatial, temporal and contrast resolution, resulting in marked improvement in the quality of two-dimensional, three-dimensional reconstructions and the virtual endoluminal evaluation of smaller structures.
Virtual hysterosalpingography is a new, less invasive modality that combines the technique of conventional X-ray hysterosalpingography with the advanced technology of multi-detector CT, resulting in a significant improvement in the visualization and assessment of fallopian tubes and allowing a more precise characterization of elevated lesions of dif¬ferent sizes being competitive with hysteroscopy, in addition to its ability to evaluate extra uterine pelvic pathology as ovarian cyst and mass.
The current work was designed to evaluate the capability of multi-detector virtual hysterosalpingography in the assessment of female infertility.
To fulfill such purpose, 25 patients with diagnosis of primary or secondary infertility were examined with both X-ray hysterosalpingography and multi-detector virtual hysterosalingography.
The radiological findings of both examinations were compared with reference final results – which were created by the results of both examinations- to avoid underestimating MDCT VHSG diagnostic value if X-ray HSG was used as the reference.
Then the diagnostic value of both examinations was calculated as regard per lesion pathology and per patient pathology, and were compared with each other.
The MDCT VHSG was more sensitive and specific for uterine tube pathology and per patient pathology than X-ray HSG, and also more specific for fallopian tube pathology than X-ray HSG.
The inter-method agreement between MDCT VHSG and X-ray HSG was very good for uterine pathology and good for fallopian tube pathology and per patient pathology.
The mean procedure duration, mean patient effective dose and median patient discomfort of both examinations were also compared.
The radiation dose is an important issue, especially for young female seeking pregnancy, where the radiation is focused on the ovary and other pelvic structures, in the this study; the MDCT VHSG has an advantage of exposing patient to less radiation dose as compared to X-ray HSG.
The MDCT VHSG was found to be a well tolerated examination, with less patient discomfort and less examination duration than X-ray HSG.
Conclusions:
On the basis of this study results which involved 25 patients evaluated with 64-row MDCT VHSG, the 64-row MDCT VHSG is a valuable technique in the evaluation of the female reproductive tract, being more tolerable examination. The evaluation of the parauterine pelvic structures and less radiation exposure are great advantages of this new procedure.
RECOMMENDATIONS
MDCT VHSG could be further explored as a new diagnostic alternative in the infertility workup.
Further studies with large number of cases are needed to confidently complement and/or substitute MDCT VHSG for X-ray HSG.