From Big Medical Encyclopedia

METROSALPINGOGRAFIYA (grech, metra a uterus + salpinx a pipe + grapho to write, represent; synonym: gisterosalpingografiya, gisterografiya, metrografiya) — a method of X-ray inspection of a uterus and uterine tubes by means of introduction to them of a contrast agent. The m is widely applied in obstetric and ginekol, practice.

Indications and Contraindications

Indications: suspicion of pathology of a uterus — a malformation, myoma, especially at a submucosal arrangement of a node, internal endometriosis, polyposes and a hyperplasia of an endometria, and also tuberculosis of uterine tubes, infertility etc.

Contraindications: acute inf. diseases, acute and subacute inflammatory processes of a uterus and appendages, periods, the increased individual sensitivity to iodine.

A technique

Before M. clear intestines and empty a bladder. The patient is stacked in situation for vulval operations. The vagina and neck of uterus are processed the tampons moistened in alcohol and by means of special adaptation (most often various modifications of a cannula Schultz) enter a contrast agent into a uterus — 50% the solution of Cardiotrastum, Verografinum or Iodolipolum which are warmed up to body temperature. At the same time the tip of a cannula shall close densely an ostium of the uterus that a contrast agent did not pour out in a vagina. The first picture produce after introduction 2 — 3 ml of a contrast agent for obtaining the image of a relief of a mucous membrane of a uterus. Then enter 5 — 10 more ml of a contrast agent (at the same time there occur harder filling of a cavity of the uterus and a part of a contrast agent gets into uterine tubes and an abdominal cavity) and make the second, and if necessary and the third picture. Usually for all procedure it is spent apprx. 10 — 15 ml of a contrast agent. During the use of Iodolipolum the third picture for the purpose of control of passability of uterine tubes is made next day. Depending on a research objective and the estimated diagnosis of M. it is necessary to carry out to various phases of a menstrual cycle: at suspicion of internal endometriosis of M. carry out on 7 — the 8th day, at infertility and istmiko-cervical insufficiency — to the second phase of a menstrual cycle.

Fig. 1. Metrosalpingogramma is normal: 1 — a cavity of the uterus, 2 — the right pipe, 3 — the left pipe, 4 — accumulations of a contrast agent in an abdominal cavity.

Results of a research

In the analysis of roentgenograms (fig. 1) should be considered that normal the cavity of the uterus has the form of an isosceles triangle, edges can change depending on a phase of a menstrual cycle; uterine tubes have an appearance of thin twisting strips.

At inflammatory changes of uterine tubes expansion of isthmic department is usually observed. The so-called sactosalpinx looks as considerable expansion of an ampoule of a uterine tube.

Fig. 2. Metrosalpingogramma at a tubercular salpingitis: the cavity of the uterus (1) is filled with a contrast agent; uterine tubes (2) it is club-shaped are expanded, a contrast agent from them does not get into an abdominal cavity (Impassability of pipes).

At a genital tuberculosis at the beginning of a disease reinforced folds of a mucous membrane of ampullar departments of uterine tubes come to light. In their gleam defects of filling and a kaltsinata, contours of uterine tubes uneven can be defined. In later stages of process gleams of uterine tubes are narrowed, their isthmic departments become impassable, and ampullar have bulavoobrazny expansions on the ends (fig. 2).

At endometriosis of uterine tubes on a metrosalpingogramma the multiple peritubarny courses in the form of short strokes or points are visible.

At pipe pregnancy limited expansion more often than ampullar department of a uterine tube decides on defects of filling; contours of fetal egg can be sometimes visible.

Fig. 3. Metrosalpingogramma at commissural process in a small basin: a contrast agent fills ampullar departments of uterine tubes (1) and the sacculated cavities in a small basin (2).

At commissural process in an abdominal cavity can be defined various size and a form of accumulation of a contrast agent in the sacculated cavities (fig. 3).

See also Uterus , Uterine tubes .

Bibliography: Abdurasulov D. M. and Ishchenko of G. T. Tservikogisterosalpingografiya in gynecology, Tashkent, 1976; Abramova M. M. Atlas of a gisterosalpingografiya, M., 1963; Constant and-nesku P. and Morariu of V. Gisterosalpingografiya in gynecologic and obstetric practice, the Atlas, the lane from Romanians., Bucharest, 1973; Marshalekya. izhenishka of L. Radiodiagnosis of diseases of a female genital, the lane from Czeches., Prague, 1963; Pobedinsky N. M., In about l about at e in A. I. and Gudkov M. V. Improvement of a technique and equipment of a gisterosalpingografiya, Medical tekhn., No. z, page 49, 1974; P mustache and Ya. I N. A contrast X-ray analysis in gynecology, M., 1959.

H. M. Pobedinsky.