RadiologySpirit: hysterosalpingography

Showing posts with label hysterosalpingography. Show all posts

Sunday, July 4, 2010

Hysterosalpingogram in 40-year-old woman shows medium-sized cesarean section scar defect arising from left lower uterine cavity wall (arrow).

http://www.ajronline.org/cgi/content/full/190/4/870/FIG1

Hysterosalpingogram in 37-year-old woman shows linear cesarean section scar defect at uterine isthmus (arrows).

Tubal polyp. Spot radiograph shows a small filling defect (arrow) in the proximal left fallopian tube, a finding that typically represents a tubal polyp.

http://radiographics.rsna.org/content/26/2/419.figures-only

. Irreversible tubal occlusion with a microinsert. (a) Scout radiograph obtained prior to the instillation of contrast material shows a microinsert that has been placed hysteroscopically into the proximal fallopian tube. (b) Radiograph obtained after instillation shows no contrast material filling of the fallopian tube beyond the microinsert, a finding that helps document tubal occlusion.

http://radiographics.rsna.org/content/26/2/419.figures-only

Peritubal adhesions. Spot radiograph demonstrates a round collection of contrast material adjacent to the left fallopian tube, a finding that suggests peritubal adhesions. Note the free contrast material spillage on the right side.

http://radiographics.rsna.org/content/26/2/419.figures-only

Hydrosalpinx. (a) Steep right oblique spot radiograph shows dilatation of the ampullary portion of the right fallopian tube (arrow). The left fallopian tube is normal in caliber. Mucosal folds are visible in the ampullary portions of both fallopian tubes, a finding that helps confirm the presence of contrast material within the tubes. (b) Spot radiograph shows dilatation of the ampullary portion of the left fallopian tube, a finding that is consistent with a hydrosalpinx. No contrast material spillage is seen on the left side. The right fallopian tube is abruptly cut off, a finding that is consistent with previous tubal ligation.

http://radiographics.rsna.org/content/26/2/419.figures-only

Tubal occlusion. (a) Spot radiograph demonstrates abrupt cutoff of the left fallopian tube. (b) Spot radiograph demonstrates cutoff of contrast material in the isthmic portions of both fallopian tubes, with bulbous dilatation of the distal aspects of the opacified portions. These findings can be seen with postsurgical occlusion (eg, following tubal ligation).

http://radiographics.rsna.org/content/26/2/419.figures-only

Cornual spasm. (a) On an HSG spot radiograph obtained during the early filling stage of the uterus, the right fallopian tube does not opacify beyond the cornual portion (arrow), whereas the left fallopian tube opacifies to the ampullary portion. Arrowheads indicate amorphous calcifications on the right side of the pelvis. These calcifications were also present on the scout image (not shown). (b) On a spot radiograph obtained after the instillation of additional contrast material, the right fallopian tube opacifies to the ampullary portion. Right-sided SIN and a left-sided hydrosalpinx are also noted. Amorphous calcifications (arrowheads) are again seen on the right side of the pelvis.

http://radiographics.rsna.org/content/26/2/419.figures-only

SIN. Spot radiograph demonstrates SIN as small outpouchings or diverticula from the isthmic portion of the fallopian tubes. SIN can be either unilateral or (as in this case) bilateral.

http://radiographics.rsna.org/content/26/2/419.figures-only

Cesarean section scar. Spot radiograph shows the uterine incision from a cesarean section (arrows) in the typical location (ie, oriented transverse in the lower uterine segment in the region of the isthmus). At HSG, a cesarean section scar can have a linear appearance (as in this case) or can occasionally manifest as a wedge-shaped outpouching or diverticulum.

http://radiographics.rsna.org/content/26/2/419.figures-only

(a, b) Diffuse adenomyosis. (a) Spot radiograph shows irregularity of the uterine contour with small outpouchings of contrast material, findings that represent diffuse adenomyosis. (b) Sagittal T2-weighted MR image shows thickening of the junctional zone to more than 1 cm, especially in the anterior fundus. (c, d) Focal adenomyosis. (c) Spot radiograph demonstrates an irregular mass-like filling defect in the fundus with small contrast material–filled diverticula, findings that represent focal adenomyosis. (d) Transabdominal US image shows thickening of the posterior uterine fundus with a heterogeneous echotexture in the area of focal adenomyosis (cf c).

Friday, July 2, 2010

Leiomyomas. (a) Spot radiograph obtained during the early filling stage shows a well-defined filling defect (arrow) in the fundus. (b) On a spot radiograph obtained with the uterus more distended with contrast material, the fibroid (arrow) is less apparent. (c) Spot radiograph obtained in a different patient reveals a large leiomyoma distorting the endometrial cavity as it drapes over a mass in the left myometrium. (d) Sonohysterogram obtained in a third patient shows a retroverted uterus with fluid outlining a submucosal mass in the fundus. The balloon of an HSG catheter (arrow) is seen in the lower uterine segment.

http://www.google.com.eg/imgres?imgurl=http://radiographics.rsna.org/content/26/2/419/F12.small.gif&imgrefurl=http://radiographics.rsna.org/content/26/2/419.figures-only&usg=__VpUj1hDYgg3gkRJ5XSe6l8I_dXA=&h=192&w=200&sz=34&hl=en&start=44&itbs=1&tbnid=bQ3pvndRAhzw_M:&tbnh=100&tbnw=104&prev=/images%3Fq%3Dhysterosalpingography%26start%3D40%26hl%3Den%26sa%3DN%26gbv%3D2%26ndsp%3D20%26tbs%3Disch:1

Endometrial polyp. Sagittal sonohysterogram shows a large, well-defined mass in the fundus arising from the anterior aspect of the endometrium. Note the cystic area in the lower portion of the polyp.

http://www.google.com.eg/imgres?imgurl=http://radiographics.rsna.org/content/26/2/419/F12.small.gif&imgrefurl=http://radiographics.rsna.org/content/26/2/419.figures-only&usg=__VpUj1hDYgg3gkRJ5XSe6l8I_dXA=&h=192&w=200&sz=34&hl=en&start=44&itbs=1&tbnid=bQ3pvndRAhzw_M:&tbnh=100&tbnw=104&prev=/images%3Fq%3Dhysterosalpingography%26start%3D40%26hl%3Den%26sa%3DN%26gbv%3D2%26ndsp%3D20%26tbs%3Disch:1

Synechiae. (a) Spot radiograph shows a central oval filling defect within the uterus, a finding that represents a synechia. (b) Spot radiograph obtained in a different patient demonstrates a short linear defect (arrow) along the inferior left side near the uterine isthmus.

Uterine folds. HSG spot radiograph demonstrates uterine folds (arrows) as linear filling defects that parallel the longitudinal axis of the uterus. Uterine folds are normal findings that are occasionally seen at HSG.

http://www.google.com.eg/imgres?imgurl=http://radiographics.rsna.org/content/26/2/419/F12.small.gif&imgrefurl=http://radiographics.rsna.org/content/26/2/419.figures-only&usg=__VpUj1hDYgg3gkRJ5XSe6l8I_dXA=&h=192&w=200&sz=34&hl=en&start=44&itbs=1&tbnid=bQ3pvndRAhzw_M:&tbnh=100&tbnw=104&prev=/images%3Fq%3Dhysterosalpingography%26start%3D40%26hl%3Den%26sa%3DN%26gbv%3D2%26ndsp%3D20%26tbs%3Disch:1

A-

B-

Air bubbles. (a) Spot radiograph shows air bubbles (arrow) in the left side of the uterus. (b) Spot radiograph no longer depicts the air bubbles seen in the left cornua of the uterus in a. Air bubbles are often mobile or transient when they are expelled into the fallopian tubes.