MR-HSG kao sigurna, pouzdana i nedovoljno korištena metoda

Introduction: Hysterosalpingography (HSG) is the gold standard for assessing fallopian tube patency, but it involves ionizing radiation and iodinated contrast medium. Magnetic resonance hysterosalpingography (MR-HSG) allows assessment of tubal patency without ionizing radiation, while offering superior visualization of pelvic soft tissues.Aim: To evaluate the diagnostic value of MR-HSG in assessing fallopian tube patency, with particular emphasis on the MRI protocol, and to compare the findings with those obtained using conventional HSG.Materials and methods: Fifty patients were included. All underwent MR-HSG followed immediately by HSG. During MR-HSG, a diluted gadolinium contrast solution was administered in the uterine cavity. The protocol consisted of T2-weighted sequences and dynamic T1-weighted imaging. The presence of contrast solution adjacent to the ovaries and in the pouch of Douglas was recorded as an indicator of tubal patency. Agreement between the methods was assessed using Cronbach’s alpha coefficient.Results: Bilateral tubal occlusion was confirmed in 6 cases (12%). Cronbach’s alpha demonstrated excellent agreement between the methods (0.97 for the left ovary; 0.84 for the right ovary; 0.80 for the pouch of Douglas). No adverse effects were observed.Conclusion: MR-HSG is an effective, well-tolerated method with high agreement with HSG. Its advantages include the absence of ionizing radiation and superior visualization of pelvic soft tissues. MR-HSG may be considered a reliable alternative to HSG.