Nomogram-based predictive model for intra-myometrial contrast agent reflux using imaging features from 4D...

Area of Science:

• Reproductive Medicine
• Medical Imaging
• Infertility Diagnostics

Background:

• Rising global infertility rates necessitate improved diagnostic techniques.
• Hysterosalpingo-contrast sonography (HyCoSy) is crucial for infertility evaluation.
• Contrast agent reflux into the myometrium is a complication of HyCoSy, with limited predictive methods.

Purpose of the Study:

• To identify imaging risk factors for intra-myometrial contrast agent reflux during four-dimensional (4D) HyCoSy.
• To develop a nomogram-based predictive model for intra-myometrial contrast reflux.
• To aid clinical decision-making in managing HyCoSy procedures.

Main Methods:

• Retrospective analysis of 1,274 infertile women undergoing 4D HyCoSy.
• Classification into reflux (n=234) and non-reflux (n=1,040) groups.
• Logistic regression for predictor identification and nomogram construction, with internal validation.

Main Results:

• Significant predictors included age, infertility type, history of gynecological surgery, and procedural discomfort.
• Imaging factors like endometrial thickness and tubal patency differed between groups.
• The nomogram model demonstrated good predictive performance (AUC=0.854).

Conclusions:

• A nomogram model integrating infertility type, endometrial thickness, contrast dose, and symptoms effectively predicts intra-myometrial contrast reflux.
• This tool assists clinicians in implementing preventive measures.
• Reduces the risk of contrast leakage and associated complications in HyCoSy procedures.