Risk Factors of Contrast Agent Intravasation With Sulfur Hexafluoride Microbubble During Hysterosalpingo-Contrast Sonography

J Ultrasound Med. 2023 Jul;42(7):1587-1594. doi: 10.1002/jum.16179. Epub 2023 Jan 13.

Abstract

Objectives: To analyze the risk factors of sulfur hexafluoride microbubble contrast agent intravasation during hysterosalpingo-contrast sonography (HyCoSy), and to explore a simple prediction model by the obvious clinical history.

Methods: This was a retrospective study included 299 infertility women who had undergone HyCoSy examination from July 1, 2018 to June 31, 2019. The factors were recorded, including age, endometrial thickness, balloon length, infertility type, history of intrauterine surgery, history of pelvic surgery, and tubal patency. The method of multivariate logistic regression analysis was adopted to analyze the risk factors affecting the contrast agent intravasation, and the receiver operating characteristic curves were plotted to test their efficacy.

Results: Secondary infertility, a history of intrauterine surgery, thin endometrial thickness, and tubal obstruction were all risk factors of the occurrence of intravasation (P < .05). And the area under the receiver operating characteristic curves of the multifactor-combined prediction model of the intravasation was significantly larger than that of single-factor.

Conclusions: Sonographers and gynecologists should be familiar with the risk factors of intravasation and select the appropriate timing of HyCoSy toward reducing the occurrence of intravasation and other complications after thoroughly explaining and communicating with the patients.

Keywords: contrast agent; fallopian tube patency; hysterosalpingo-contrast sonography; infertility; intravasation; ultrasonography.

MeSH terms

  • Contrast Media* / adverse effects
  • Fallopian Tube Patency Tests / methods
  • Fallopian Tubes / diagnostic imaging
  • Female
  • Humans
  • Hysterosalpingography / methods
  • Infertility, Female* / diagnostic imaging
  • Infertility, Female* / etiology
  • Microbubbles
  • Retrospective Studies
  • Risk Factors
  • Sulfur Hexafluoride
  • Ultrasonography / methods

Substances

  • Contrast Media
  • Sulfur Hexafluoride