输卵管超声造影对输卵管通畅性的诊断价值

The clinical application study of hysterosalpingography in tubal origin infertility

目的探讨输卵管超声造影对输卵管通畅性的诊断价值。方法 30例输卵管源性不孕患者,腹腔镜术前全麻条件下行低机械指数SonoVue输卵管超声造影,实时观察造影剂在子宫、输卵管内显影情况,并与腹腔镜检查结果进行对照。结果输卵管超声造影诊断输卵管狭窄31条,闭塞8条,通畅18条;5条输卵管超声造影考虑通畅,手术中发现输卵管远端积水或粘连闭锁,美蓝通液试验不通;3条输卵管造影考虑远端狭窄或闭塞,腹腔镜下美蓝通液实验通畅。与腹腔镜下美蓝通液检查比较,输卵管超声造影诊断输卵管通畅性的敏感性为87.8%,特异性为78.3%,准确性为86.0%,阳性预测值为92.3%,阴性预测值为72.2%。结论输卵管造影准确率较高、无创、简便,可免除放射线影响,并可反映输卵管病变原因,具有较高的临床价值。

Objective To study the clinical value of contrast-enhanced ultrasound technique in the diagnosis of tubal infertility. Methods Thirty patients were included before laparoscopic surgery. Hysterosalpingography ultrasound imaging was after anesthesia. The real-time ultrasound images of contrast agent in the endometrial cavity and tubal lumen were observed and the results were compare with those from laparoscopy and dyeing examination. Results There was no significaat difference between the imaging results and the laparoscopic methylene blue test with the positive predictive value of 92.3% and the negative predictive value of 72.2%. The sensitivity specifity and accurancy degree of contrast-enhanced uhrasourd exanination in uherine fallopian tuse were 87.8% ,78.3%, 86.0% ,vespectively. The positive pvedicive and negative preditie value were 92.3% and was 72.2%. Thirty one cases were diagnosed as fallopian tube stenosis by uterine fallopian tube contrast-enhanced ultrasound, 8 obstructed, 18 unobstructed. Remote water or adhesion tubal closure were found during operation in 5 cases which were diagnosed as oviduct tubes by contrast-enhanced ultrasound. But they were found obstructed by methylene blue test. Three cases were cosidered as fallopian tube or obstructed in the remote fallopian tube while methylene blue test in the laparascope showed they were open. Conclusion The technique of contrast-enhanced ultrasound in uterine fallopian tube posseses high clinical value and may reflect the cause of tubal disease with advantages of high accuracy, non-invasiveness, easy operation and non-radioactive effects.