子宫输卵管三维超声造影与X线碘油造影的比较

Diagnostic Performance of Three-dimensional Hysterosalpingo-contrast Sonography versus X-ray Hysterosalpingography

目的探讨经阴道子宫输卵管三维超声造影(3D-HyCoSy)在检查输卵管通畅性方面的应用价值。方法 40例不孕症患者分别接受3D-HyCoSy和X线子宫输卵管碘油造影(HSG),其中5例接受了腹腔镜检查,比较3D-HyCoSy和HSG在评价输卵管通畅性方面的差异。结果 3D-HyCoSy获得的子宫宫腔和输卵管图像立体、清晰,引起的不良反应小。40例患者中,3D-HyCoSy与HSG均显示输卵管通畅41条,通而不畅8条,阻塞18条,两者诊断符合率为84.8%,Kappa分析结果提示两种检查方法评价输卵管通畅性的一致性"较好"(P值=0.000,Kappa值=0.729)。与5例腹腔镜检查结果相比,3D-HyCoSy与HSG的诊断准确率均为100%。结论 3D-HyCoSy能全面、准确、客观、安全地评价输卵管通畅情况,有望成为诊断输卵管通畅性的首选检查方法。

Objective To explore the clinic value of transvaginal three-dimensional hysterosalpingo-contrast sonography（3D-HyCoSy）in diagnosing fallopian tube patency.Methods Forty infertile women were subject to 3D-HyCoSy and X-ray hysterosalpingography（HSG）,respectively.Among these patients,5underwent laparoscopy.The accuracy of assessment of fallopian tube patency was compared between 3D-HyCoSy and X-ray HSG.Results The stereo pictures of the uterus cave were obtained on 3D-HyCoSy.The fallopian tube was clearly visualized without obvious adverse reactions occurring.Forty-one fallopian tubes were diagnosed as patent,8as partially patent and 18as non-patent by both 3D-HyCoSy and X-ray HSG.The diagnosis accordance rate was 84.8%,and the two methods had a good consistency（P=0.000,Kappa=0.729）.The accurate diagnosis rate was 100%in both 3D-HyCoSy and X-ray HSG when compared with the results of laparoscopy.Conclusion 3D-HyCoSy can evaluate the fallopian tube patency accurately,objectively and safely.It holds promises to become a powerful tool for inspection of fallopian tube patency.