Assessment of Multidetector CT Virtual Hysterosalpingography as a Reliable Modality for the Evaluation of Female Genital System Abnormalities

Background: virtual hysterosalpingography is a novel, noninvasive modality that combines the capabilities of multidetector CT with the established technique of hysterosalpingography to allow a simultaneous non-invasive evaluation of the entire uterine wall, uterine cavity, cervix and Fallopian tubes. The evaluation of the para-uterine pelvic structures is considered as a great advantage of the procedure that can be an alternative diagnostic technique in the infertility workup algorithm. Virtual hysterosalpingography with the reconstruction of two-dimensional, three-dimensional, and virtual endoscopic views allows a comprehensive evaluation of the female reproductive system with a single imaging test, it gives well-appointed anatomic information and a detailed characterization of the different pathologic processes.  In comparison with HSG, US and MR imaging techniques that have been used for the diagnostic work-up of female infertility; virtual hysterosalpingography provides more detailed information about abnormalities of the cervix, uterus, Fallopian tubes and other pelvic structures and it may allow a more accurate evaluation of tubal patency. However, the resultant exposure of the patient to ionizing radiation is a relative disadvantage that must be weighed against the clinical purpose.
Aim of the work: this study aimed to evaluate the role of virtual CT hysterosalpingography as a new noninvasive modality for the assessment of the uterus and the Fallopian tubes abnormalities. Conclusion: VHSG has the ability to integrate most of the advantages of the diagnostic studies methods in the diagnosis and evaluation of the infertile female. Whether it should completely replace the use of standard conventional HSG among the infertile females, or be used as a back up to HSG and indicated when questionable or abnormal findings are encountered.