经阴道子宫输卵管四维超声造影评价输卵管通畅性的研究

Evaluation of the patency of fallopian tubes by transvaginal four-dimensional hysterosalpingo-contrast sonography

目的探讨经阴道子宫输卵管四维超声造影(4D-HyCoSy)在输卵管通畅性评价中的临床应用价值。方法对160例不孕不育妇女进行4D-HyCoSy检查,分析所获得图像,评估其输卵管通畅性;其中49例随后进行子宫输卵管碘油造影(HSG),72例进行腹腔镜检查。结果 160例患者316条输卵管(其中1例为单角子宫,3例曾行单侧输卵管切除术)4DHyCoSy显示输卵管通畅209条,输卵管通而不畅43条,输卵管不通64条。其中49例同时进行HSG检查,总体符合率约97.9%(96/98),72例同时进行腹腔镜检查,总体符合率约91.4%(128/140)。结论 4D-HyCoSy能动态立体显示输卵管形态,准确评价输卵管通畅性,可作为不孕不育患者输卵管检查的首选检查方法。

Objective： To explore the clinical application value of transvaginal four-dimensional hysterosalpingo- contrast sonography（4D-HyCoSy）in assessing the patency of fallopian tubes. Methods： The patency of fallopian tube of 160 infertile women was evaluated by analyzing the image of 4D-HyCoSy. Subsequently 49 patients were detected by X-ray hysterosalpingography（X-ray HSG）and 72 patients were accepted the examination of laparoscopy. Results： A total of 316 fallopian tubes of 160 patients（one patient had unicornuate uterus,3 patients underwent unilateral salpingectomy）were evaluated by 4D-HyCoSy. Among them, 209 fallopian tubes were unobstructed,43 incomplete blocked,and 64 blocked. Subsequently 49 patients were examined with X-ray HSG and 72 patients were detected by laparoscopic. The coincidence rates were 97.9Y0 （96/98）and 91.4% （ 128/140 ） respectively. Conclusions： 4D-HyCoSy can dynamically and three-dimensionally display the shape of fallopian tubes,and accurately evaluate the liquidity of fallopian tubes. It is the first choice for detecting fallopian tubes of infertile patients.