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Re: U/S contrast agent use for tubal patFrom: Spnglr@aol.comFri Aug 7 23:10:49 1998
In a message dated 98-08-06 20:01:28 EDT, you write: << Am I correct to think that the contrast agent could be administered after the saline injection? I would like to know that I would get some useful information from the initial exam and not use the first patient for "practice". >> This is correct. Do the saline (negative contrast) study first for evaluation of the endometrial cavity, then instill a few mL of microbubble ( positive) contrast followed by a saline flush. I have found that it is best to scan in the coronal plane, focused on the cornua. Each side scanned individually. If there is flow of contrast through the interstitial portion of the tube, move the probe to focus on the ipsilateral ovary. You should be able to see contrast "moving" around the ovary if the tube is indeed patent. A small volume of positive contrast is typically sufficient per attempt and will dissipate fairly quickly in the event that another attempt is necessary. When we began performing these procedures, we tried to visualize the fimbria to actually see the microbubbles exiting the tube. This required a greater volume of saline and often rendered a confusing image. We found that the method described above correlated well with radiographic HSG's. As far as "practicing" on your first patient is concerned, you may have no choice unless you can find a volunteer. Everyone has to start somewhere and, like any other type of sonography, your eye will become more accustomed to picking up the contrast as you grow in experience. Good luck! Nancy
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