子宫输卵管碘造影与超声子宫水造影诊断女性不孕症的临床研究

Clinical study on hysterosalpingography and saline influsion hysterosonography for diagnos in infertilie women

目的评价子宫输卵管碘造影(HSG)与超声子宫水造影(SIS)对于女性不孕症子宫腔病变诊断价值。方法96例女性不孕症患者,同时行HSG与SIS,以宫腔镜(HS)和病理结果(Pathol)为标准,计算两种方法诊断子宫内膜息肉、黏膜下肌瘤、宫腔粘连及子宫腔畸形的敏感性、特异性、Youden指数和Kappa值。结果37例患者被诊断患有子宫腔病变。HSG诊断内膜息肉、黏膜下肌瘤、宫腔粘连的敏感性、特异性、Youden指数和Kappa分别为0.78、0.97、0.67、0.79;0.92、0.99、0.83、0.91;0.88、0.98、0.62、0.81。SIS的各参数分别为0.83、0.99、0.79、0.86;1.00、0.99、0.92、0.95;0.50、0.99、0.38、0.59。HSG和SIS诊断子宫腔畸形的各参数均为1.00。结论与传统的HSG相比,SIS对女性不孕子宫腔病变的诊断有很高的敏感性和特异性,而且简便易行、疼痛轻微、并发症少。

Objective： To evaluate the diagnostic role of hysterosalpingography （HSG） and Saline influsion hysterosonography （SIS） in the detection of uterine cavity abnormalities of infertilie women. Methods： Ninty -six patients of infertilie women were evaluated by HSG and SIS, The diagnostic parameters of two techniques were compared with hysteroscopic （HS） and pathologic （Pathol） results. Results： Thirty - seven infertilie women were found to have uterine cavity abnormalities. The sensitivity, specificity Youdens Index and Kappa of HSG in polypi, submucous myomas and metrosynizesis were 0. 78, 0. 97, 0. 67, 0. 79 ; 0. 92, 0. 99, 0. 83, 0.91; 0.88, 0.98, 0.62, 0.81, respectively. Those of SIS were 0.83, 0.99, 0.79, 0.86; 1.00, 0.99, 0.92, 0.95; 0.50, 0.99, 0. 38, 0. 59, respectively. All diagnostic parameters in uterine cavity malformation of two techniques were 1.00. Conclusion： In comparison with HSG, SIS is an excellent technique with very high sensitivity and specificity for uterine cavity abnormalities. This procedure can be easily performed and well to lerated by patients without complications.