***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The purpose of this study was to compare sulfur hexafluoride microbubble (SonoVue)-enhanced myocardial contrast echocardiography ( MCE ) with single-photon emission computed tomography ( SPECT ) relative to coronary angiography ( CA ) for assessment of coronary artery disease ( CAD ) . BACKGROUND Small-scale studies have shown that myocardial perfusion assessed by SonoVue-enhanced MCE is a viable alternative to SPECT for CAD assessment . However , large multicenter studies are lacking . METHODS Patients referred for myocardial ischemia testing at 34 centers underwent rest/vasodilator SonoVue-enhanced flash-replenishment MCE , st and ard (99m)Tc-labeled electrocardiography-gated SPECT , and quantitative CA within 1 month . Myocardial ischemia assessment s by 3 independent , blinded readers for MCE and 3 readers for SPECT were collapsed into 1 diagnosis per patient per technique and were compared to CA ( reference st and ard ) read by 1 independent blinded reader . RESULTS Of 628 enrolled patients who received SonoVue ( 71 % males ; mean age : 64 years ; > 1 cardiovascular [ CV ] risk factor in 99 % of patients ) 516 patients underwent all 3 examinations , of whom 161 ( 31.2 % ) had ≥70 % stenosis ( 131 had single-vessel disease [ SVD ] ; 30 had multivessel disease ) , and 310 ( 60.1 % ) had ≥50 % stenosis . Higher sensitivity was obtained with MCE than with SPECT ( 75.2 % vs. 49.1 % , respectively ; p < 0.0001 ) , although specificity was lower ( 52.4 % vs. 80.6 % , respectively ; p < 0.0001 ) for ≥70 % stenosis . Similar findings were obtained for patients with ≥50 % stenosis . Sensitivity levels for detection of SVD and proximal disease for ≥70 % stenosis were higher for MCE ( 72.5 % vs. 42.7 % , respectively ; p < 0.0001 ; 80 % vs. 58 % , respectively ; p = 0.005 , respectively ) . CONCLUSIONS SonoVue-enhanced MCE demonstrated superior sensitivity but lower specificity for detection of CAD compared to SPECT in a population with a high incidence of CV risk factors and intermediate-high prevalence of CAD . ( A phase III study to compare SonoVue ® enhanced myocardial echocardiography [ MCE ] to single photon emission computerized tomography [ ECG-GATED SPECT ] , at rest and at peak of low-dose Dipyridamole stress test , in the assessment of significant coronary artery disease [ CAD ] in patients with suspect or known CAD using Coronary Angiography as Gold St and ard-SonoVue MCE vs SPECT ; EUCTR2007 - 003492 - 39-GR ) OBJECTIVE To demonstrate the diagnostic efficacy of 2D B-mode , color and pulsed Doppler Hy-Co-Sy and 3D B-mode and power Doppler Hy-Co-Sy . STUDY DESIGN AND METHODS One hundred and fifty-two women were recruited into the 2D B-mode , color and pulsed Doppler Hy-Co-Sy study and 116 other women were recruited into the 3D B-mode and power Doppler Hy-Co-Sy study .  We assessed the diagnostic performance ( sensitivity , specificity , PPV and NPV ) of 2D and 3D Hy-Co-Sy , compared to hysteroscopy , and laparoscopy and dye test in the assessment of uterine abnormalities and tubal patency , respectively . RESULTS The sensitivity , specificity , PPV and NPV of 2D hysterosonography compared to hysteroscopy were 93.6 , 97.3 , 98.2 and 97.3 % , respectively . The sensitivity , specificity , PPV and NPV of 3D hysterosonography  compared to hysteroscopy were 97.9 , 100 , 97.9 and 100 % , respectively . Addition of color and pulsed Doppler to 2D Hy-Co-Sy and power Doppler to 3D Hy-Co-Sy contributed to diagnostic precision in detection of tubal patency . The sensitivity , specificity , PPV and NPV of 3D power Doppler Hy-Co-Sy in detection of tubal patency compared to laparoscopy and dye intubation were 100 , 99.1 , 99.2 and 100 % , respectively . CONCLUSION 2D and 3D Hy-Co-Sy are accurate methods for evaluation of uterine abnormalities and tubal patency in infertile patients OBJECTIVE The evaluation of the role of sonohysterosalpingography with saline with air as a contrast solution ( HYCOSY ) , in the assessment of uterine cavity and tubal patency , versus hysterosalpingography ( HSG ) and laparoscopy with dye test combined with hysteroscopy . MATERIAL AND METHOD Prospect i ve study of 95 infertility patients , with ages 25 - 40 years ( median 31 ) , in which HYCOSY was compared with HSG regarding the diagnostic acuracy for uterine cavity pathology and tubal patency , and compared to laparoscopy with dye test combined with hysteroscopy as gold st and ard . RESULTS The sensibility , specificity , positive predictive value ( PPV ) and negative predictive value ( NPV ) for the diagnostic of uterine cavity pathology was : HYCOSY versus hysteroscopy of 72.1 % , 96.15 % , 93.93 % and 80.64 % respectively ; HSG versus hysteroscopy was 83.3 % , 60.7 % , 63.6 % and 81.6 % ; both methods combined versus hysteroscopy 95.34 % , 61.53 % , 67.21 % and 94.11 % . The same parameters for the tubal patency were :  HYCOSY  versus  dye test laparoscopy 81.39 % , 87.69 % , 67.30 % and 97.79 % ; HSG versus dye test laparoscopy 61.9 % , 85.3 % , 56.5 % and 87.9 % ; both methods combined versus dye test 86 % , 76 % , 52.9 % and 94.6 % . CONCLUSION HYCOSY can be used in combination with HSG for selecting the patients that need further more invasive investigations , in order to describe uterine and tubal pathology OBJECTIVE To evaluate the effectiveness of modified hysterosalpingography using <3 mL amount of contrast medium followed by injection of saline to minimize the adverse effects associated with the procedure . DESIGN For modified hysterosalpingography , 1 - 2 mL of water-soluble contrast medium were injected to visualize the uterine cavity , followed by injection of 10 mL of saline to check tubal patency and spillage . A control group of patients underwent hysterosalpingography with undiluted contrast medium . SETTING Teaching hospital . PATIENT(S ) Seventy-eight infertile women [ study ( n = 40)/control ( n = 38 ) groups ] . INTERVENTION(S ) Modified and st and ard hysterosalpingography . MAIN OUTCOME MEASURE(S ) Assessment of uterine cavity , tubal patency , and sensation of pain during modified hysterosalpingography was compared with that during  st and ard hysterosalpingography .  RESULT ( S ) Uterine cavity and tubal patency were properly visualized during modified hysterosalpingography . Saline pushed the contrast medium successfully from the uterine cavity through the open fallopian tubes and into the pelvic cavity . The study group reported significantly less pain than did the control group . Between-group differences were statistically significant when pain perception ( no pain vs. minimal pain vs. severe pain ; no pain vs. any kind of pain ) was analyzed by type of adnexal pathology ( bilateral passage or unilateral passage ) . CONCLUSION ( S ) Modified hysterosalpingography was sufficient to diagnose tubal and pelvic mechanical factors . The procedure was associated with a significant reduction in self-reported pain and no medical complications UNLABELLED Hystero-salpingo-contrast sonography ( HyCoSy ) is a sensitive method of assessing tubal patency but can not completely substitute diagnostic laparoscopy with blue dye and hysteroscopy . Three-dimensional sonography has new imaging facilities which could lead to a reduction of invasive diagnostic procedures . AIM The aim of this pilot study was to analyse the feasibility of HyCoSy by 3D- and 3D-Doppler-sonography . METHODS In a prospect i ve setting conventional ( 2D ) HyCoSy was performed in 21 patients with an ultrasound device design ed for 3D-ultrasound .  After the completion of the 2D procedure , 3D-ultrasound was carried out . In five patients an additional 3D-Doppler-HyCoSy was performed . The generated 3D-volumina were then examined . Laparoscopy with blue dye was performed immediately after the ultrasound examination . RESULTS A total of 42 Fallopian tubes was assessed . On 2D-ultrasound , visibility of the tubes was excellent in 28 and limited in seven tubes . Of the seven tubes not visible on 2D-ultrasound , four were not patent on laparoscopy . On 3D-ultrasound , visibility of the tubes was excellent in 15 and limited in twelve tubes . 15 tubes were not visible on 3D-ultrasound . 3D-Doppler-HyCoSy revealed excellent assessment in eight of ten tubes , even in one of those with limited visibility on 2D- and 3D-HyCoSy . In 19 patients the assessment of the uterine cavity was excellent by 2D- and 3D-HyCoSy , whereas it was limited in two patients . CONCLUSION It is possible to visualise the full length of the tubes in a very detailed way from the uterine cavity to the fimbrial end in some patients , but the diagnostic power of HyCoSy is not improved by adding 3D-imaging . The accuracy of 3D-ultrasound seemed to be improved by 3D-Doppler-ultrasound OBJECTIVE To evaluate the feasibility of transvaginal hysterosalpingo-contrast sonography ( HyCoSy ) with new automated three-dimensional coded contrast imaging ( 3D-CCI ) software in the evaluation of tubal patency and visualization of tubal course . METHODS Patients undergoing HyCoSy with automated 3D-CCI software  were evaluated prospect ively . First , to evaluate the feasibility of 3D visualization of tubal course , we performed consecutive volume acquisitions while injecting SonoVue contrast agent . We then performed conventional two-dimensional ( 2D ) real-time HyCoSy to confirm tubal patency status by detection of saline and air bubbles moving through the Fallopian tubes and around the ovaries . We also evaluated visualization with CCI of the contrast agent around the ovaries , side effects and pain during and after the procedure , by visual analog scale ( VAS ) ( ranging from 0 to 10 , with 0 corresponding to no pain and 10 corresponding to maximum pain ) . RESULTS A total of 126 patients ( 252 tubes ) underwent 3D-CCI HyCoSy followed by 2D real-time HyCoSy . According to the final 2D real-time evaluation , bilateral tubal patency was observed in 111 patients , bilateral tubal occlusion in four patients and unilateral tubal patency in 11 patients . The concordance rate for tubal patency status between the first 3D volume acquisition and the final 2D real-time evaluation was 84 % and that between the second 3D volume acquisition and the final 2D real-time evaluation was 97 % . A pain score > 5 on VAS was recorded in 58 % of patients during the procedure , but a pain score ≤ 5 was recorded in 85.7 % of patients immediately after the procedure . CONCLUSIONS HyCoSy with automated 3D-CCI technology retains the advantages of conventional 2D HyCoSy while overcoming the disadvantages . 2D HyCoSy is highly observer-dependent and is only accurate in the h and s of experienced investigators ; by obtaining a volume of the uterus and tubes , automated 3D volume acquisition permits visualization of the tubes in the coronal view and of the tubal course in 3D space , and should allow less experienced operators to evaluate tubal patency status relatively easily 
    Output:
    
3D/4D HyCoSy is an accurate test for diagnosing tubal patency in infertile females .
ADVANCES IN KNOWLEDGE 3D/4D HyCoSy is an accurate test for diagnosing tubal patency in females suffering from infertility , whilst overcoming some main limitations of other methods .