الفهرس 
The Female Reproductive SystemOnly 14 pages are availabe for public view
 |  | from | 157 |  |  |
| | | from | 157 | | |
Abstract
Female infertility is a serious problem that faces many couples all over the word.
Female infertility has wide range of causes including ovulatory, fallopian and uterine problems.
HSG plays an importantnt role in the evaluation of abnormalities related to the uterus and fallopian tubes. Uterine and tubal abnormalities that can be detected by HSG include multiple conditions as congenital anomalies, polyps, leiomyomas, surgical changes, synechiae, and adenomyosis, tubal occlusion, salpingitis isthmica nodosum, polyps, hydrosalpinx, and peritubal adhesions.
Although HSG is considered to be the golden standard in evaluation of female infertility, yet it carries 3 disadvantages; first of all, the hazards of ioninzing radiation that should be avoided in women of reproductive age, second, the risk of complications as bleeding and infection and finally, the problem of HSG in being restricted to the imaging of endoluminal structure and thus many of extracavitary and extratubal pathologies maybe missed.
MRI has been used to detect a wide range of conditions that affect fertility, yet fallopian tube patency continues to be inferred from images obtained at conventional hysterosalpingography (HSG). Here comes the role of MR hysterosalpingography (MR HSG) since it can be considered as a single comprehensive examination when
both conventional HSG and standard MRI are necessary in the workup of women with infertility. This imaging approach causes less pain and avoids exposure of the ovaries to ionizing radiation but at the same time takes more time and have higher cost. By intra uterine injection of a higher viscosity MR-contrast agent and a fat-saturated 3D gradient-echo sequence was performed to correspond to the subsequent HSG images, it allows not only visualization of uterine cavity and Fallopian tube patency but also direct visualization of Fallopian tubes.
Also, tubal patency can be effectively assessed with a clinically available MR angiographic sequence (3D TRICKS) to correspond to the subsequent HSG images. This capability enhances the already established value of MRI for the evaluation of uterine and extra uterine abnormalities.
Thus we can state at the moment that the advantages of less pain during the examination, of more information about all organs of the true pelvis and especially of avoidance of exposure to ionizing radiation, do compensate for the longer examination time and for the expected higher costs of the MR hystrosapingography, which might evolve to a well-accepted alternative to conventional HSG and probably even replace this old method in the near future.