Feasibility of 2-Hour vs 24-Hour Delayed Radiography in Oil-Based Hysterosalpingography: A Comparative Diagnostic Accuracy Study.

BACKGROUND Hysterosalpingography (HSG) plays an important role in assessing the patency and functional integrity of the fallopian tubes and is crucial for female fertility evaluation. This study explored the feasibility of shortening delayed radiography time by comparing the consistency of 2- and 24-hour post-HSG radiographs for tubal patency diagnosis. MATERIAL AND METHODS This prospective comparative study enrolled 2 cohorts: the experimental group underwent delayed radiographs at 2 hours after HSG, and the control group at 24 hours after HSG. To confirm radiographic findings and inform therapeutic interventions aimed at improving fertility, all patients subsequently underwent hysteroscopy with chromopertubation (HSC) within the following month, establishing the reference standard for tubal assessment. Using HSC findings as the benchmark, we assessed the diagnostic value of the 2-hour and 24-hour delayed images. All patients were followed for clinical pregnancy outcomes via telephone or email for 12 months. RESULTS A total of 194 patients underwent delayed radiographs 24 hours after HSG, and 203 at 2 hours after HSG. The McNemar-Bowker test indicated that both the 2-hour and 24-hour delayed radiograph results differed significantly from the HSC reference (P<0.001), although with moderate agreement (kappa, approximately 0.6). The accuracy, precision, sensitivity, and specificity of the 2 groups were similar. There was no significant difference in pregnancy rate within 1 year between the groups (P=0.596). CONCLUSIONS A 2-hour delayed radiograph is a viable alternative to a conventional 24-hour delayed radiograph. However, these preliminary findings require validation through randomized trials, in which each patient serves as their own control.