Prevalence of Uterine Anomalies in Computed Tomography Virtual Hysterosalpingography Studies

Abstract

Study question: Is the computed tomography virtual hysterosalpingography (CTVHSG) a useful imaging study for the diagnosis of uterine malformations?
Summary answer: CT-VHSG is a useful imaging modality for the detection and characterization of uterine anomalies, also providing information on the uterine wall and cavity and tubal patency in a single examination.
The already known: More than 10 years ago, CT-VHSG has demonstrated its usefulness and good performance in the correct evaluation of the female reproductive system, obtaining advantageous results compared to other methods.
Study design: The following is a retrospective observational study based on data from patients who underwent CTVHSG from January 2010 to December 2019 at our institution.
Materials and Methods: 11512 patients with suspected or diagnosed infertility from January 2010 to December 2019 were studied with a CT-VHSG between days 6 and 11 of the menstrual cycle.
The images are reprocessed on a workstation using different reconstruction algorithms.
Main results: 11512 patients with a mean age of 35.7 +/- 4.8 years were studied. The mean radiation dose of the studies was 0.6 +/- 0.2 mSv. Uterine abnormalities were found in 459 of the patients (4%), including 171 patients with an arcuate uterus, 46 with a unicornuate uterus, 34 with a bicornuate uterus, 101 with a partial septate uterus, 85 with a complete septate uterus, and 13 with didelphus uterus.
Study limitations: the present study does not show a correlation with a reference method such as magnetic resonance imaging of the pelvis.
Wider implications of the findings: show that CT-VHSG not only provides us with information on tubal patency, but also allows us to evaluate women of childbearing age in a more comprehensive way, such as the detection and characterization of uterine malformations.