子宫输卵管四维超声造影在不孕症中的诊断价值

Diagnostic Value of Four-dimensional Hysterosalpingo-contrast Sonography for Infertility

目的 探讨子宫输卵管四维超声造影在不孕症中的诊断价值。方法 选取2013年5～11月临床诊断不孕症患者45例（86条输卵管），抽取配制好的SonoVue微泡混悬液1ml＋19ml灭菌生理盐水，在造影模式及经阴道超声监视下缓慢注入官腔，连续观察双侧输卵管显影情况。结果 45例共86条输卵管，超声造影显示输卵管通畅47条，阻塞15条，通而不畅24条。超声与X线造影结果符合率96.5％（83／86）。10例输卵管阻塞患者腹腔镜手术后半年内妊娠4例，其他35例半年内妊娠9例。结论 子宫输卵管四维超声造影操作简单，创伤轻微，重复性好，无辐射，可代替X线碘油造影判断不孕症患者输卵管的通畅性。

Objective To explore the diagnostic value of four-dimensional hysterosalpingo-contrast sonography （4D-HyCoSy） in the treatment of infertility. Methods A total of 45 cases of clinical infertility were selected. The 1 ml SonoVue suspension was mixed with 19 ml sterile normal saline, and was injected into uterine cavity slowly under transvaginal ultrasound with opacification mode. The image development of bilateral oviducts was observed. Results There were 86 oviducts of 45 patients. 4D-HyCoSy showed that 47 oviducts were unobstructed, 24 were partially obstructed and 15 were obstructed. 4D-HyCoSy and X-ray examination confirmed 96.5% （83/86） of the above results. Four of ten patients with tubal obstruction got pregnant within six months after laparoscopic surgery, and nine of the rest 35 cases got pregnant within 6 months. Conclusions 4D-HyCoSy is simple, minimally invasive and repeatable. It is free of radiation, so it can be used to detect the oviduct patency of infertile patients in place of X-ray lipiodol.