{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T20:33:01Z","timestamp":1773088381763,"version":"3.50.1"},"reference-count":51,"publisher":"Scientific Scholar","content-domain":{"domain":["clinicalimagingscience.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Objectives:<\/jats:title>\n<jats:p>Presently, hysterosalpingography (HSG) is used as a means to evaluate women with infertility and repetitive pregnancy loss. Venous intravasation is a complication and potential pitfall during HSG and analogous procedures including hysteroscopy. The aim of our study was to assess the venous intravasation and to obtain critical information for more secure and more accurate procedures. In particular, the primary goal of the present study was to compare HSG without and with intravasation to identify differences seen on HSG and to assess the predisposing factors of intravasation. The secondary goal was to describe clinical- and imaging-based novel classification of intravasation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Materials and Methods:<\/jats:title>\n<jats:p>This study included a patient cohort of 569 patients who underwent HSG between 2008 and 2011 at our center in the absence (control group) or presence (study group) of intravasation. Intravasation classified from level 0 (no intravasation) to level 3 (severe intravasation) was compared with preprocedural (demographic and clinical) and procedural (HSG) data. Data were analyzed using Statistical Package for Social Sciences (SPSS) statistical software.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results:<\/jats:title>\n<jats:p>Of the 569 patients undergoing HSG, 528 showed no intravasation and 41 (7.2%) patients showed intravasation when associated with preprocedural (leukocytes, menometrorrhagia, secondary infertility, ectopic pregnancy, abortus, polycystic ovaries, endometriosis, and interventions) and procedural (pain, scheduling, endometrial-uterine nature, and spillage) parameters. Moreover, intravasation was lower in women with smooth endometrium, triangular uterus, and homogeneous peritoneal spillage. No association was found between age, tubal patency, increased pressure, and intravasation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusions:<\/jats:title>\n<jats:p>Using a novel classification method, intravasation can be observed in women during HSG and associates with preprocedural and procedural predisposing factors in subsumed conditions. This classification method will be useful for improving the efficiency and accuracy of HSG and related procedures by minimization of severe complications caused by intravasation.<\/jats:p>\n<\/jats:sec>","DOI":"10.4103\/2156-7514.124105","type":"journal-article","created":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T06:51:50Z","timestamp":1388559110000},"page":"67","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Venous Intravasation as a Complication and Potential Pitfall During Hysterosalpingography: Re-Emerging Study with a Novel Classification"],"prefix":"10.25259","volume":"3","author":[{"given":"Abdurrahim","family":"Dusak","sequence":"first","affiliation":[{"name":"Department of Radiology, Dicle University, Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatice E.","family":"Soydinc","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dicle University, Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakan","family":"Onder","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dicle University, Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faysal","family":"Ekinci","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dicle University, Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neval Y.","family":"G\u00f6r\u00fck","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dicle University, Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cihat","family":"Hamidi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dicle University, Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aslan","family":"Bilici","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dicle University, Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2013,12,31]]},"reference":[{"key":"10.4103\/2156-7514.124105\/ref-1","first-page":"153","article-title":"Uterosalpingography","volume":"27","author":"Perry","year":"1935","journal-title":"J Natl Med Assoc"},{"key":"10.4103\/2156-7514.124105\/ref-2","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1046\/j.1440-1673.2001.00893.x","article-title":"Hysterosalpingography","volume":"45","author":"Livsey","year":"2001","journal-title":"Australas Radiol"},{"key":"10.4103\/2156-7514.124105\/ref-3","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1148\/rg.262055109","article-title":"Hysterosalpingography: A reemerging study","volume":"26","author":"Simpson","year":"2006","journal-title":"Radiographics"},{"key":"10.4103\/2156-7514.124105\/ref-4","first-page":"178","article-title":"Structural findings at hysterosalpingography in patients with infertility at two private clinics in Kampala, Uganda","volume":"4","author":"Kiguli-Malwadde","year":"2004","journal-title":"Afr Health Sci"},{"key":"10.4103\/2156-7514.124105\/ref-5","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.2214\/ajr.183.5.1831405","article-title":"Diagnostic value of hysterosalpingography in the detection of intrauterine abnormalities: A comparison with hysteroscopy","volume":"183","author":"Roma","year":"2004","journal-title":"AJR Am J Roentgenol"},{"key":"10.4103\/2156-7514.124105\/ref-6","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1093\/humrep\/deg256","article-title":"Hysteroscopic sterilization using a micro-insert device: Results of a multicentre Phase II study","volume":"18","author":"Kerin","year":"2003","journal-title":"Hum Reprod"},{"key":"10.4103\/2156-7514.124105\/ref-7","doi-asserted-by":"crossref","first-page":"24","DOI":"10.2214\/AJR.05.0836","article-title":"Hysterosalpingography and sonohysterography: Lessons in technique","volume":"186","author":"Lindheim","year":"2006","journal-title":"AJR Am J Roentgenol"},{"key":"10.4103\/2156-7514.124105\/ref-8","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.ejogrb.2007.01.016","article-title":"Re-evaluation of the indication for and limitation of laparoscopic salpingotomy for tubal pregnancy","volume":"137","author":"Fujishita","year":"2008","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.4103\/2156-7514.124105\/ref-9","first-page":"368","article-title":"Hysterosalpingography: Current applications","volume":"48","author":"Eng","year":"2007","journal-title":"Singapore Med J"},{"key":"10.4103\/2156-7514.124105\/ref-10","doi-asserted-by":"crossref","first-page":"675","DOI":"10.2214\/ajr.157.4.1892018","article-title":"Hysterosalpingography in the 1990s","volume":"157","author":"Isabel","year":"1991","journal-title":"AJR Am J Roentgenol"},{"key":"10.4103\/2156-7514.124105\/ref-11","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1093\/humrep\/13.1.75","article-title":"Hysterosalpingography with a balloon catheter versus a metal cannula: A prospective, randomized, blinded comparative study","volume":"13","author":"Tur-Kaspa","year":"1998","journal-title":"Hum Reprod"},{"key":"10.4103\/2156-7514.124105\/ref-12","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/BF03011933","article-title":"Sorbitol 2.5% mannitol 0.54% irrigation solution for hysteroscopic endometrial ablation surgery","volume":"44","author":"Moir","year":"1997","journal-title":"Can J Anaesth"},{"key":"10.4103\/2156-7514.124105\/ref-13","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1148\/radiology.154.3.3969459","article-title":"Salpingitis isthmica nodosa: Radiologic and clinical correlates","volume":"154","author":"Creasy","year":"1985","journal-title":"Radiology"},{"key":"10.4103\/2156-7514.124105\/ref-14","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/00001703-200208000-00008","article-title":"Complications in hysteroscopy: Prevention, treatment and legal risk","volume":"14","author":"Bradley","year":"2002","journal-title":"Curr Opin Obstet Gynecol"},{"key":"10.4103\/2156-7514.124105\/ref-15","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1148\/radiology.180.1.1647040","article-title":"Selective injection of contrast media: Inflammatory effects on rabbit fallopian tubes","volume":"180","author":"Thurmond","year":"1991","journal-title":"Radiology"},{"key":"10.4103\/2156-7514.124105\/ref-16","first-page":"26","article-title":"Pericaval intravasation of contrast media in the changed indication for hysterosalpingography","volume":"37","author":"Gowin","year":"1984","journal-title":"Rontgenblatter"},{"key":"10.4103\/2156-7514.124105\/ref-17","first-page":"309","article-title":"Intravasation during hystero-salpingography using using oil-base contrast medium: A second look","volume":"70","author":"Nunley","year":"1987","journal-title":"Obstet Gynecol"},{"key":"10.4103\/2156-7514.124105\/ref-18","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1148\/radiology.179.1.1848715","article-title":"Diagnostic quality and complications of hysterosalpingography: Oil versus water-soluble contrast media: A randomized prospective study","volume":"179","author":"Lindequist","year":"1991","journal-title":"Radiology"},{"key":"10.4103\/2156-7514.124105\/ref-19","first-page":"26","article-title":"Echogenic foci mimicking adenomyosis presumably due to air intravasation into the myometrium during sonohysterography","volume":"13","author":"Ors","year":"2007","journal-title":"Diagn Interv Radiol"},{"key":"10.4103\/2156-7514.124105\/ref-20","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1007\/s11547-011-0714-5","article-title":"Adenomyosis: From the sign to the diagnosis. Imaging, diagnostic pitfalls and differential diagnosis: A pictorial review","volume":"116","author":"Valentini","year":"2011","journal-title":"Radiol Med"},{"key":"10.4103\/2156-7514.124105\/ref-21","doi-asserted-by":"crossref","first-page":"131","DOI":"10.2214\/ajr.177.1.1770131","article-title":"Hysterosalpingography: Spectrum of normal variants and nonpathologic findings","volume":"177","author":"Ubeda","year":"2011","journal-title":"AJR Am J Roentgenol"},{"key":"10.4103\/2156-7514.124105\/ref-22","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1148\/radiographics.8.6.3060910","article-title":"The current state of hysterosalpingography","volume":"8","author":"Wolf","year":"1988","journal-title":"Radiographics"},{"key":"10.4103\/2156-7514.124105\/ref-23","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/j.1440-1843.2003.00524.x","article-title":"Pulmonary and cerebral oil embolism after hysterosalpingography with oil soluble contrast medium","volume":"9","author":"Uzun","year":"2004","journal-title":"Respirology"},{"key":"10.4103\/2156-7514.124105\/ref-24","doi-asserted-by":"crossref","first-page":"537.e11","DOI":"10.1016\/j.ajog.2007.01.012","article-title":"Trial of labor and vaginal birth aft er cesarean section in patients with uterine M\u00fclleriananomalies: A population-based study","volume":"196","author":"Erez","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"10.4103\/2156-7514.124105\/ref-25","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/0020-7292(86)90033-0","article-title":"Fertility after the demonstration of intravasation during hysterosalpingography","volume":"24","author":"Ron","year":"1986","journal-title":"Int J Gynaecol Obstet"},{"key":"10.4103\/2156-7514.124105\/ref-26","doi-asserted-by":"crossref","first-page":"319","DOI":"10.7863\/jum.2012.31.2.319","article-title":"The unicornuate uterus and its variants: Clinical presentation, imaging findings, and associated complications","volume":"31","author":"Khati","year":"2012","journal-title":"J Ultrasound Med"},{"key":"10.4103\/2156-7514.124105\/ref-27","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1093\/humrep\/deh205","article-title":"Endometrial and subendometrial blood flow measured during early luteal phase by three-dimensional power Doppler ultrasound in excessive ovarian responders","volume":"19","author":"Ng","year":"2004","journal-title":"Hum Reprod"},{"key":"10.4103\/2156-7514.124105\/ref-28","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/j.1471-0528.2008.02039.x","article-title":"The feasibility of a less invasive method to assess endometrial maturation: Comparison of simultaneously obtained uterine secretion and tissue biopsy","volume":"116","author":"van der Gaast","year":"2009","journal-title":"BJOG"},{"key":"10.4103\/2156-7514.124105\/ref-29","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1111\/j.1447-0756.1983.tb00614.x","article-title":"The effect of intra-uterine device on the endometrial pattern","volume":"9","author":"Nayel","year":"1983","journal-title":"Asia Oceania J Obstet Gynaecol"},{"key":"10.4103\/2156-7514.124105\/ref-30","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1016\/j.fertnstert.2004.03.069","article-title":"NICHD National Cooperative Reproductive Medicine Network. Histological dating of timed endometrial biopsy tissue is not related to fertility status","volume":"82","author":"Coutifaris","year":"2004","journal-title":"Fertil Steril"},{"key":"10.4103\/2156-7514.124105\/ref-31","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.theriogenology.2004.10.018","article-title":"Hysterographic appearance and uterine histology at different stages of the reproductive cycle and after progestagen treatment in the domestic cat","volume":"64","author":"Chatdarong","year":"2005","journal-title":"Theriogenology"},{"key":"10.4103\/2156-7514.124105\/ref-32","first-page":"223","article-title":"Therapeutic efficacy of hysterosalpingography with special reference to application of hydrostatic pressure during the procedure","volume":"1","author":"Hussain","year":"2007","journal-title":"Int J Health Sci (Qassim)"},{"key":"10.4103\/2156-7514.124105\/ref-33","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.ejogrb.2010.12.040","article-title":"Glycodelin in endometrial flushing fluid and endometrial biopsies from infertile and fertile women","volume":"156","author":"Bentin-Ley","year":"2011","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.4103\/2156-7514.124105\/ref-34","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1016\/j.fertnstert.2004.07.932","article-title":"Grading a developmental continuum: Elegy on the rise and fall of the endometrial biopsy","volume":"82","author":"McDonough","year":"2004","journal-title":"Fertil Steril"},{"key":"10.4103\/2156-7514.124105\/ref-35","first-page":"583","article-title":"An unexpected role for anticoagulant heparan sulfate proteoglycans in reproduction","volume":"136","author":"de Agostini","year":"2006","journal-title":"Swiss Med Wkly"},{"key":"10.4103\/2156-7514.124105\/ref-36","doi-asserted-by":"crossref","first-page":"2608","DOI":"10.1093\/humrep\/deg495","article-title":"Unsuspected pregnancy at hysterosalpingography: A report of three cases with different outcomes","volume":"18","author":"Cheung","year":"2003","journal-title":"Hum Reprod"},{"key":"10.4103\/2156-7514.124105\/ref-37","doi-asserted-by":"crossref","first-page":"77","DOI":"10.2214\/ajr.157.1.1675547","article-title":"Organic vs functional obstruction of the fallopian tubes: Differentiation with prostaglandin antagonist- and\/\u01312-agonist-mediated hysterosalpingography and selective ostial salpingography","volume":"157","author":"Lang","year":"1991","journal-title":"AJR Am J Roentgenol"},{"key":"10.4103\/2156-7514.124105\/ref-38","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1177\/147323001003800524","article-title":"The effect of flurbiprofen as prophylactic analgesic before hysterosalpingography","volume":"38","author":"Guzel","year":"2010","journal-title":"J Int Med Res"},{"key":"10.4103\/2156-7514.124105\/ref-39","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/s00276-003-0137-7","article-title":"Classical and nerve-sparing radical hysterectomy: An evaluation of the risk of injury to the autonomous pelvic nerves","volume":"25","author":"Ercoli","year":"2003","journal-title":"Surg Radiol Anat"},{"key":"10.4103\/2156-7514.124105\/ref-40","first-page":"E184","article-title":"The spectrum of pelvic inflammatory disease","volume":"14","author":"Ghiatas","year":"2004","journal-title":"Eur Radiol"},{"key":"10.4103\/2156-7514.124105\/ref-41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/humrep\/17.1.1","article-title":"Investigation of the infertile couple: Should diagnostic laparoscopy be performed after normal hysterosalpingography in treating infertility suspected to be of unknown origin?","volume":"17","author":"Fatum","year":"2002","journal-title":"Hum Reprod"},{"key":"10.4103\/2156-7514.124105\/ref-42","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.2214\/ajr.183.6.01831725","article-title":"Enhanced fertility after diagnostic hysterosalpingography using oil-based contrast agents may be attributable to immunomodulation","volume":"183","author":"Yun","year":"2004","journal-title":"AJR Am J Roentgenol"},{"key":"10.4103\/2156-7514.124105\/ref-43","first-page":"51","article-title":"Distribution of causes of infertility in patients attending primary fertility clinics in Israel","volume":"13","author":"Farhi","year":"2011","journal-title":"Isr Med Assoc J"},{"key":"10.4103\/2156-7514.124105\/ref-44","first-page":"18","article-title":"Venous intravasation: A potential pitfall of confirmatory hysterosalpingogram following essure hysteroscopic sterilization","volume":"6","author":"Chang","year":"2012","journal-title":"J Radiol Case Rep"},{"key":"10.4103\/2156-7514.124105\/ref-45","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.ijgo.2009.07.026","article-title":"Contemporary hysteroscopic methods for female sterilization","volume":"108","author":"Smith","year":"2010","journal-title":"Int J Gynaecol Obstet"},{"key":"10.4103\/2156-7514.124105\/ref-46","first-page":"CD001501","article-title":"Endometrial resection\/ablation techniques for heavy menstrual bleeding","author":"Lethaby","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"10.4103\/2156-7514.124105\/ref-47","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/GCO.0b013e32814a6473","article-title":"Intra-uterine adhesions and fertility outcome: How to optimize success?","volume":"19","author":"Kodaman","year":"2007","journal-title":"Curr Opin Obstet Gynecol"},{"key":"10.4103\/2156-7514.124105\/ref-48","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1097\/GRF.0b013e3182353d68","article-title":"Clinical management of the uterine factor in infertility","volume":"54","author":"Hatasaka","year":"2011","journal-title":"Clin Obstet Gynecol"},{"key":"10.4103\/2156-7514.124105\/ref-49","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1136\/bmj.300.6720.304","article-title":"Absorption of glycine irrigating solution during transcervical resection of endometrium","volume":"300","author":"Baumann","year":"1990","journal-title":"BMJ"},{"key":"10.4103\/2156-7514.124105\/ref-50","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1093\/humrep\/del088","article-title":"A cost-utility analysis of hysterectomy, endometrial resection and ablation and medical therapy for menorrhagia","volume":"21","author":"You","year":"2006","journal-title":"Hum Reprod"},{"key":"10.4103\/2156-7514.124105\/ref-51","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1093\/humrep\/dei440","article-title":"Warming echovist contrast medium for hysterocontrastsonography and the effect on the incidence of pelvic pain. A randomized controlled study","volume":"21","author":"Nirmal","year":"2006","journal-title":"Hum Reprod"}],"container-title":["Journal of Clinical Imaging Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/clinicalimagingscience.org\/venous-intravasation-as-a-complication-and-potential-pitfall-during-hysterosalpingography-re-emerging-study-with-a-novel-classification\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/clinicalimagingscience.org\/venous-intravasation-as-a-complication-and-potential-pitfall-during-hysterosalpingography-re-emerging-study-with-a-novel-classification\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T05:06:16Z","timestamp":1567141576000},"score":1,"resource":{"primary":{"URL":"https:\/\/clinicalimagingscience.org\/venous-intravasation-as-a-complication-and-potential-pitfall-during-hysterosalpingography-re-emerging-study-with-a-novel-classification\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,12,31]]},"references-count":51,"alternative-id":["10.4103\/2156-7514.124105"],"URL":"https:\/\/doi.org\/10.4103\/2156-7514.124105","relation":{},"ISSN":["2156-7514"],"issn-type":[{"value":"2156-7514","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12,31]]},"article-number":"67"}}