Lipiodol visibility under ultrasound

Area of Science:

• Reproductive medicine
• Medical imaging
• Gynecological procedures

Background:

• Lipiodol, an oil-based contrast, is used in hysterosalpingogram (HSG) but not hysterosalpingo contrast sonography (HyCoSy).
• Evidence suggests tubal flushing with Lipiodol improves fertility in unexplained infertility.
• This study explores Lipiodol's potential use in HyCoSy for enhanced tubal flushing benefits.

Purpose of the Study:

• To determine if Lipiodol is sonographically visible.
• To identify optimal agitation and ultrasound settings for Lipiodol visibility.
• To compare Lipiodol's visibility against agitated saline in HyCoSy.

Main Methods:

• Sonographers used model pelvises to record images of agitated Lipiodol and agitated saline.
• Varying Lipiodol agitation levels and ultrasound settings were tested.
• Images were evaluated by blinded reporters using a 1-5 visibility scale.

Main Results:

• Agitated Lipiodol (agitated five times) showed visibility scores similar to or greater than agitated saline.
• Optimal agitation facilitated microbubble formation, enhancing sonographic visibility.
• Statistical analysis confirmed Lipiodol's comparable or superior visibility (P > 0.7 or P < 0.001).

Conclusions:

• Sonographic visualization of agitated Lipiodol is comparable or superior to agitated saline.
• Lipiodol's potential use in HyCoSy offers oil-based tubal flushing benefits.
• This approach avoids HSG radiation and allows for pelvic soft-tissue evaluation.