Hysterosalpingography (HSG) is a common X-ray imaging procedure used in reproductive health investigations. It employs a contrast dye to visualize internal structures of the female reproductive system.
Understanding HSG’s Purpose
HSG primarily evaluates the uterine cavity and fallopian tubes. During the procedure, a healthcare professional injects a radio-opaque dye into the cervical canal. This dye flows into the uterine cavity, allowing its shape and structure to be visualized through X-ray imaging, often using fluoroscopy, which provides real-time video.
As the dye fills the fallopian tubes, medical professionals assess their patency, or openness. If unblocked, the dye spills into the surrounding peritoneal cavity. HSG identifies conditions like fallopian tube blockages, which can impact fertility, or uterine abnormalities, including polyps, fibroids, scarring, and congenital anomalies.
HSG and Ovarian Cysts
An HSG is not designed to detect ovarian cysts. The procedure focuses on visualizing the uterus and fallopian tubes. The contrast dye fills these structures, allowing assessment of their shape and patency.
The ovaries are outside the direct pathway of the injected dye. Therefore, the dye does not enter or outline the ovaries. HSG does not provide direct visualization of ovarian cysts or fibroids. Its utility lies in identifying issues related to the uterine cavity and fallopian tube function.
Diagnosing Ovarian Cysts
When an ovarian cyst is suspected, several diagnostic methods are employed. Pelvic ultrasound is the most common first-line imaging tool, performed transvaginally or transabdominally. This technique uses sound waves to create detailed images of the ovaries, confirming a cyst’s presence, location, and whether it is fluid-filled or solid.
A physical examination may also indicate a cyst. Blood tests, such as a CA-125 test, may be ordered. While CA-125 levels can be elevated in ovarian cancer, they also rise due to non-cancerous conditions like endometriosis, fibroids, pelvic inflammatory disease, or pregnancy. Therefore, a CA-125 test alone is not definitive for diagnosing all ovarian cysts.
For complex cases or inconclusive ultrasound results, advanced imaging like Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans may be used. MRI provides detailed images useful for characterizing tissue composition. CT scans help identify larger tumors and assess potential spread, though they involve radiation and are less specific for primary cyst detection than ultrasound. Consulting a healthcare professional is important for accurate diagnosis and management.