Comparison of the Diagnostic Consistency between Delayed Radiographs taken Two Hours and Twenty-four Hours Post Hysterosalpingography using Ultra-Fluid Lipiodol-based Contrast Medium

Background: Hysthyosalpingography (HSG) is commonly used to diagnose fallopian tubal disease. At the same time, a 24-hour interval is needed for taking delayed radiographs post-HSG using an oil-based contrast medium, which is inconvenient. Objective: This study used an Ultra-Fluid Lipiodol-based contrast medium to compare the diagnostic consistency between delayed radiographs taken 2 hours and 24 hours post-HSG. Methods: In total, 78 patients who received HSG examinations using ultrafluid lipiodol were enrolled in this cohort study. Then, after 2 hours and 24 hours, delayed radiographs were taken, which were subsequently randomized and assigned to two folders and read by investigators to assess the patency of the fallopian tubes, uterine morphology, and pelvic cavity morphology. Results: The delayed radiographs that were taken 2 hours and 24 hours post-HSG revealed substantial agreement in the diagnosis of fallopian tube patency (with a Gwet’s AC1 value of 0.624) and almost perfect agreement in determining uterine morphology (with a Gwet’s AC1 value of 0.943) and pelvic cavity morphology (with a Gwet’s AC1 value of 0.876). Twenty-nine (37.2%) and 3 (3.8%) patients experienced mild and moderate pain, respectively, and 3 (3.8%) patients suffered countercurrent blood flow during the HSG. After HSG, only 9 (11.5%) patients were exposed to mild pain. Vaginal bleeding did not occur either during or after HSG. Conclusion: Taking delayed radiographs 2 hours post-HSG using Ultra-Fluid Lipiodol exhibits high consistency in evaluating tubal patency and uterine and pelvic cavity morphology compared with the traditional 24-hour scheme.