经阴道实时三维超声造影评价输卵管通畅性的初步研究

A primary study of transvaginal real-time three-dimensional hysterosalpingo-contrast sonography in the assessment of tube patency

目的探讨经阴道声诺维实时三维超声造影（RT3D-HyCoSy）评价输卵管通畅性的可行性和准确性。方法对96例不孕症患者共191条输卵管行RT3D-HyCoSy检查，将获得的图像质量进行评估，其中35例与腹腔镜检查结果对照，比较两种检查方法的一致性，并对RT3D-HyCoSy的诊断效能进行评估。结果191条输卵管RT3D-HyCoSy的图像质量评分为（2．94±0．26）分。RT3D-HyCoSy与腹腔镜检查的一致性较高，x值为0．802（Pd0．001），其判断输卵管阻塞的敏感性、特异性、阳性预测值、阴性预测值、准确性分别为87．5％（14／16）、94．4%（51／54）、82．3％（14／17）、96．2％（51／53）、92．9％（65／70）。结论经阴道RT3D-HyCoSy可准确显示输卵管的形态并对其通畅性作出评估。

Objective To evaluate the feasibility and accuracy of the transvaginal real-time three- dimensional hysterosalpingo-contrast sonography（RT 3D-HyCoSy） with SonoVue in the assessment of tubal patency. Methods Tubal patency was investigated by RT 3D-HyCoSy in 96 unselected infertile patients （a total of 191 tubes）. The image quality of RT 3D-HyCoSy was evaluated. Laparoscopy was performed in 35 cases （a total of 70 tubes） of them. The efficacy of the procedure was compared with [aparoscopy. Results The mean score of image quality of RT 3D-HyCoSy in ninety-six cases was 2.94 ＋ 0.26. The accordance between RT 3D-HyCoSy and laparoscopy was good, with the Kappa value was 0. 802. Sensitivity, specificity, positive predictive value,negative predictive value and accuracy in diagnosing tubal patency by using RT 3D- HyCoSy was 87.5% （14/16）, 94. 4% （51/54）, 82.3% （14/17）, 96.2%（51/53）, 92.9% （65/70）, respectively. Conclusions Transvaginal RT 3D-HyCoSy is a good imaging technique which can display the morphological character of fallopian tube and assess the pateney.