声诺维经阴道子宫输卵管超声造影诊断不孕症的临床应用

Clinical application of SonoVue ultrasound transvaginal uterine oviduct radiography on diagnosis of infertility

目的探讨声诺维(SonoVue)经阴道子宫输卵管超声造影(SonoVue-HyCoSy)诊断不孕症的临床应用价值。方法对120例不孕症患者进行SonoVue经阴道子宫输卵管超声造影检查,在实时超声下观察造影剂通过宫腔及输卵管时的流动情况及进入盆腔后的分布情况,从而判断输卵管是否通畅及通畅程度。其结果与X线下子宫输卵管碘油造影(hysterosa1pingography,HSG)作为对照,评价SonoVue经阴道子宫输卵管超声造影的诊断符合率。结果本组120例患者,其中2例宫颈粘连插管失败,3例因推注造影剂时腹痛明显难忍而放弃,6例曾患病单侧输卵管被切除,其余224条输卵管超声造影成功。SonoVue超声造影诊断输卵管通畅性的诊断敏感性为96.1%,特异性为93.3%,准确率为94.6%。与X线子宫输卵管碘油造影评价输卵管是否通畅及通畅程度的准确性相似,无显著性差异(>0.05)。结论 SonoVue经阴道子宫输卵管超声造影是一种简便易行、无创,费用较低,有效、安全、重复性强的检查方法,诊断准确率高,具有临床推广应用价值。

Objective To investigate the clinical value of SonoVue ultrasound transvaginal uterine oviduct radio- graphy on diagnosis of infertility. Methods Transvaginal SonoVue-hysterosalpingo-contrast sonography was performed on 120 infertility patients. In order to determine whether tubal was unobstrcted or unobstructed degree, the flow of the contrast agent through the uterine cavity and fallopian tubes and the distribution in pelvic were observed in real time. Compared with X-ray hysterosalpingography （hysterosalpingography, HSG）, the coincidence rate diagnosis of SonoVue ultrasound transvaginal uterine oviduct radiography was evaluated. Results According to sonogram features of contrast a- gent SonoVue, in the group of 120 patients, 2 cases failed intuhation because of cervical adhesions, 3 cases give up of un- bearable pain under pushing injection of contrast agent, 6 cases had unilateral tubal resection because of diseases, and the rest of 224 cases were successful in tubal CEUS. Diagnostic sensitivity of SonoVue contrast-enhanced ultrasound diagnosis of tubal patency was 96.1%, specificity was 93.3 % and accuracy was 94.6 %, which was similar to the evaluation of X-ray hysterosalpingography on accuracy of tubal patency, there was no significant difference （P〉0. 05）. Conclusion SonoVue ultrasound transvaginal uterine oviduct radiography is a simple, non-invasive, low cost, effective, safe, reproducible, and high diagnostic method of examination, which can make explicite about tubal patency and obstruction site, and with good clinical application value.