What is a salpingogram and how is it done?

Hysterosalpingography is generally used to detect whether the fallopian tubes are unobstructed, and if there is blockage, the site of the blockage can be detected. Hysterosalpingography is a common examination. Female friends can learn more about it.

Hysterosalpingography was first used in the 1920s. It involves injecting iodine, a high-density substance with a high atomic number, into the uterine cavity through the cervical canal. This creates a clear artificial contrast with the surrounding tissues under X-ray film, allowing the lumen to be visualized, thereby understanding the conditions inside the uterus and fallopian tubes. Angiography can not only indicate whether the fallopian tubes are unobstructed and the location of obstruction, but also observe the morphology of the uterine cavity. This type of examination is relatively safe, does not require anesthesia, does not cause obvious pain, and is acceptable to patients.

Advantages of angiography

This examination is less invasive and, under the operation of an experienced doctor and with the use of a digital X-ray machine, can make a correct diagnosis of fallopian tube obstruction with an accuracy rate of 98%. It also has a certain therapeutic effect and is the most commonly used examination method to understand whether the fallopian tubes are unobstructed, the degree of patency, and the specific location of the blockage. In many aspects, it is irreplaceable by ultrasound, CT, MRI, hysteroscopy, laparoscopy, fallopian tube endoscopy, etc.

Imaging process

The first step is to dilate the vagina and expose the cervix. The cervix and fornix are disinfected with iohexol, the cervical catheter is filled with iohexol, the air in the tube is removed, the cervical canal is inserted along the direction of the uterine cavity, and the cervical clamp is tightened so that the conical rubber head of the catheter fits tightly against the cervix to prevent the drug from flowing out.

The second step is that during the hysterosalpingography examination, the patient lies on his back on the X-ray machine operating platform, routinely disinfects the vulva and vagina, then lays a sterile towel, and then checks the position and size of the uterus.

The third step is to observe the contrast agent flowing through the uterine cavity under X-ray fluoroscopy, and slowly inject iodized oil under fluorescent fluoroscopy. The first injection volume is 3-5 ml. Observe its entry into the uterus and flow through the fallopian tubes. At this time, a picture will be taken and then iodized oil will continue to be pushed in. The film will continue after 5-10 minutes.

The fourth step is to take another picture at the same location one day later, and then observe whether there is free iohexol in the abdominal cavity. If both fallopian tubes are blocked, there will be no iodized oil in the pelvic cavity. If there is only a small amount of iohexol, it can be considered that the fallopian tubes are obstructed.