动态三维子宫输卵管超声造影临床应用价值探讨

Clinical Application of Four-dimensional Hysterosalpingo-contrast Sonography

目的探讨经阴道动态三维(4D)子宫输卵管超声造影评价不孕症患者输卵管通畅性的临床应用价值。方法选择女性不孕症患者62例,将双腔球囊导管置入宫腔,经导管推注SonoVue超声造影剂,经4D阴道超声造影实时观察造影剂增强情况,并采用经阴道4D超声造影重建技术评估输卵管通畅性,其中3例行腹腔镜检查,15例行子宫输卵管碘油造影。结果 62例患者的120条输卵管4D超声造影显示115条,显示率95.8%;其中输卵管通畅38条,输卵管通而不畅59条,输卵管阻塞18条。4D超声造影结果与X线碘油造影结果比较具有一致性。结论经阴道子宫输卵管4D超声造影重建技术能真实展现输卵管的立体空间走行,并能准确、快速判断输卵管的通畅性,有望成为一种新的评价不孕症患者输卵管通畅性的有效手段。

Objective To assess the clinical value of 4 dimensional hysterosalpingo contrast sonography（4D HyCoSy）with SonoVue and transvaginal ultrasound（TVS）for the patency of the fallopian tube in infertile women. Methods A two-way bal- loon Foley catheter was placed into the uterus of 62 infertile women. The ultrasound contrast agent Sono Vue was injected via the Foley tube. 4D HyCoSy was performed to visualize the enhancement of the contrast agent at real time. The fallopian tube pa- tency was evaluated by the transvaginal 4D ultrasound scanning. Among the patients, three underwent the examination of lapa- roscopy and 15 X-ray hysterosalpingography （X ray HSG）. Results TVS 4D HyCoSy visualized the 115 uterine tubes （95.8~） ,among which,18 tubes were diagnosed to be blocked,59 to be incompletely blocked and 38 unobstructed. The results of 4D HyCoSy were consistent with those of X-ray HSG. Conclusion TVS 4D HyCoSy can elearly show the shape of the uter- ine tube in four dimensions. And it can accurately and quickly assess the tube patency. This technique holds promises to become a new effective method to diagnose the tube patency in patients with infertility.