Opaque pathologies in Hysterosalpingography

What is it about?

The Hysterosalpingography (HSG) not only is a reliable method for the assessment of fallopian tube patency, but also it can detect intrauterine pathologies as well as opaque pathologies outside of contrast areas. The pelvis consists of complex compartment with multiple anatomic structures. Knowledge and attention to appearances of these structures and pathologic conditions are crucial to avoid confusion and preserving high diagnostic accuracy when interpreting pelvic findings. Radiologists should conscious of possible gynecologic and nongynecological findings in HSG. An in-depth investigation and interpretation of the opaque areas in addition to contrast areas is therefore essential for obtaining reliable data. In a properly performed hysterosalpingography, in addition to the endocervix, uterine cavity, and fallopian tubes, potential anomalies outside of contrast areas of the genital tract can be seen and should be noticed. This study aimed at presenting and evaluating rarely-reported and abnormal opaque findings in HSG. The opaque pathologies irrelevant to contrast material in HSG are categorized into two groups: Pelvic tissue related and foreign body. Pelvic tissue-related anomalies are divided into gynecologic-related and non-gynecologic in type. Gynecologic related tissues: The uterine cavity and fallopian tubes are visualized as opaque portions in HSG, which normally do not involve other gynecologic organs unless they change through calcification and the growth of new masses, making a soft tissue shadow. Calcified fibromas, calcified ovarian fibromas, calcified ovarian tumor, calcified fallopian tubes and soft tissue masses are in this group. Non-Gynecologic related: Nongynecological radiopaque changes in the pelvis can be related to the bowel, urinary tracts, bone or other organs located intraperitoneal or extraperitoneal. Calcifications of non-gynecologic organs, mass-like lesions, and pelvic bone anomalies are listed in this group. Foreign bodies: Radiopaque foreign bodies that can be located intra-pelvic or out of the body. Intrapelvic foreign bodies can be medically located or inadvertently left in the pelvis by medical staff or be swallowed. Opaque objects placed out of body, in clothes or on the skin, may appear to be within the pelvic. Depending on the anatomical location, type of material, and size of the object, they may affect the evaluation of the intrapelvic organs.

Featured Image

Photo by Debora Pilati on Unsplash

Photo by Debora Pilati on Unsplash

Why is it important?

An in-depth linvestigation and interpretation of the opaque areas in addition to contrast areas is essential for obtaining reliable data.

Perspectives