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Unlabelled: PURPOSE AIM: To asses the diagnostic value of hysterosalpingo-contrast sonography (HyCoSy) with Levovist(R) as alternative to conventional hysterosalpingography (HSG) in the study of infertility., Material and Methods: From September 1988 to March 2000 we evaluated 120 patients with a history of infertility. Thirty patients underwent both HyCoSy and HSG. HyCoSy was performed in the pre-ovulatory phase of mestrual cycle. The tecnique was the same for both examinations. After administering 15 ml contrast medium, we visualized the endometrial cavity, the flow of the contrast medium along the fallopian tubes and its passage into the peritoneum., Results: In all cases Color-Power Doppler allowed visualization of the uterine cavity and of the spilling of the contrast medium into the peritoneum, yielding information on tube patency that was comparable to that obtained by conventional HSG. In 28 cases (93%) we obtained optimal visualization of the contrast medium at the level of both the endometrial cavity and the fallopian tubes. HyCoSy proved to be superior to conventional HSG in evaluating adjacent myometrial structures, adnexa and degree of follicular maturation, equal to HSG in visualizing the passage of the contrast medium into the peritoneum but inferior to HSG in imaging the fallopian tubes owing to their tortuosity., Discussion and Conclusions: The absence of ionising radiation makes HyCoSy a possible first choice examination in the evaluation of fallopian tube pathology. Conventional HSG should be kept for doubtful cases or for surgical procedures to correct mono- or bilateral obstruction.

Thirty Strecker nickel-titanium self-expanding metallic stents were implanted in 20 patients with esophageal strictures and inoperable neoplasms in the Departments of Radiology of the University School of Medicine of Ferrara, Genoa, Novara and Rome, from March 1992 to April 1993; follow-up ranged 1 to 13 months. Thanks to the stents, esophageal strictures could be dilated, significantly reducing dysphagia and allowing the patients to return on to a solid diet. Radiological and endoscopic exams proved the efficacy of the stents in all but 2 patients in whom the tumors had invaded the stent lumen and caused obstruction. In all cases the stents were highly biocompatible and well tolerated. Neither major complications, such as perforation or bleeding, were observed, nor minor ones, such as fever or migration from the site of implant, which may occur with plastic prostheses. To conclude, self-expanding metallic stents used in clinical trials for 13 months proved an effective method in the palliative treatment of malignant esophageal strictures.

Fallopian tube catheterization with selective ostial [correction of osteal] salpingography is a new technique for the diagnosis of tubal factors of infertility and also for the treatment of proximal tubal occlusion (PTO). In this study, 246 women were considered, 20-42 years old, with primary or secondary infertility, who presented a unilateral or bilateral PTO at hysterosalpingography (HSG). Catheterization and selective salpingography have been successful in 93.9% of the cases. Failures (5.6%) have been ascribed to obstructive organic diseases, where it was impossible to overcome the stenosis with the catheter or the guide-wire. Twenty-six spontaneous pregnancies were obtained (15 full-term deliveries) and 17 patients became pregnant after GIFT (13 full-term deliveries). At follow-up, after 12 months 4 of 10 patients had normal tubes, while 6 patients presented a new unilateral or bilateral PTO. No major complications occurred; nevertheless, ectopic pregnancy is a possible event, because of the mechanically re-established patency in a nonfunctioning tube.