经阴道实时三维子宫输卵管超声造影的临床应用

Value of real time three-dimensional hysterosalpingo-contrast-sonography in the assessment of fallopian tube patency

目的探讨经阴道实时三维超声造影评估子宫输卵管通畅性的准确性和临床应用价值。方法对428例不孕症妇女行经阴道实时三维子宫输卵管超声造影，其中32例行腹腔镜下通染液检查。结果428例患者846条输卵管超声造影显示输卵管通畅271条，输卵管通而不畅373条，输卵管不通畅202条，其中32例子宫输卵管超声造影与腹腔镜通液结果对照（Kappa值=0．788），经阴道实时三维超声造影评估输卵管通畅性的敏感性84．0％，特异性100％，阴性预测值87．5％，阳性预测值90．9％。结论经阴道实时三维子宫输卵管超声造影可动态显示子宫输卵管、卵巢和盆腔显影顺序和伞端形态，有利于输卵管通畅性的评估以及对输卵管功能的研究。

Objective To access the diagnostic accuracy and clinical value of transvaginal real time three-dimensional hysterosalpingo-contrast sonography （RT-3D-HyCoSy） in evaluating the fallopian tube patency. Methods 428 infertile women were under went transvaginal RT-3D-HyCoSy and 32 of them were underwent laparoscopieally salpingoraphy to evaluate the fallopian tube patency. Results 846 fallopian tubeswere studied by RT-3D-HyCoSy,271 of them were unobstructed,202 of them were obstructed,373 of them were partially passable. Compared with laparoscopically salpingography, sensitivity, specificity, positive predictive value and negative predictive value of transvaginal RT-3D HyCoSy were 84.0%, 100%, 87.5% and 90.9% ,respectively. The transvagianl RT-3D HyCoSy and the laparoscopy with a Cohen＇s Kappa was 0. 788. Conclusions Transvagianl RT-3D HyCoSy could dynamic show the visualization of the course from uterus to distal tubal and the both ovary consecutively. It has more advantage in assessing the pateney of tubal and distal tubal function.