三维超声输卵管造影与二维超声输卵管造影的比较研究

A Comparison between 3D Coded Contrast Imaging and 2D Hysterosalpingo-contrast-sonography

目的比较子宫输卵管三维超声编码造影技术（3D-CCI-HyCoSy）与二维超声造影（2D-HyCoSy）诊断不孕症患者输卵管通畅性的临床价值。方法对拟在我院进行腹腔镜通染术的70例不孕患者于术前进行超声造影检查。随机分组后,30例患者进行2D-HyCoSy,40例患者进行3D-CCI-HyCoSy。注入SonoVue后,评估输卵管通畅性。造影后3~7 d进行腹腔镜通染术。结果 2D-HyCoSy灵敏度92.3%、特异度91.2%、阳性预测值88.9%、阴性预测值93.9%。3D-CCI-HyCoSy灵敏度94.7%、特异度92.9%、阳性预测值92.3%、阴性预测值95.1%;3D-CCI-HyCoSy的ROC曲线下面积0.951,2D-HyCoSy的ROC曲线下面积0.849,2者差异具有统计学意义（P=0.021）。结论 3D-CCI-HyCoSy对子宫宫腔病变和输卵管通畅性的诊断和鉴别有着明显优势。

Objective To compare 2D hysterosalpingo-contrast-sonography （2D HyCoSy） and 3D coded contrast imaging （three-dimen- sional coded contrast imaging hysterosalpingo-contrast-sonography,3D-CCI-HyCoSy） in the diagnosis of tubal patency in infertility patients. Methods Totally 70 infertility patients underwent laparoseopy and dye were divided randomly into two groups. Thirty female patients were recruited into the 2D-HyCoSy study and 40 other female patients were recruited into the 3D-CCI-HyCoSy study. Tubal pateney were as- sessed after injection of SonoVue.The laparoscopy and dye tests were performed 3-7 d after angiography. Results The sensitivity, specifici- ty ,PPV and NPV of 2D hysterosonography compared to laparoseopy were 92.3% ,91.2%, 88.9% and 93.9% ,respectively,and those of 3D- CCI hysterosonography compared to laparoscopy were 94.7%, 92.9%, 92.3% and 95.1%, respectively. The area under ROC curve （AUC） of 2D and 3D-CCI-HyCoSy were 0.849 and 0.951,respectively,with significant difference （P =0.021）. Conclusion 3D-CCI-HyCoSy is preferable for evaluation of uterine lesions and tubal patency in infertile patients.