子宫输卵管四维超声造影中压力曲线上升斜率的临床观察

The clinical observation of the slope of the rising pressure curve in 4-dimensional hysterosalpingo-contrast sonography

目的探讨经阴道子宫输卵管四维超声造影中对比剂推注压力曲线上升斜率与输卵管通畅程度的相关性。方法采用Sono Vue对比剂对136例不孕症患者行经阴道子宫输卵管四维超声造影检查,用通液诊疗仪自动推注对比剂并记录实时推注压力并自动描绘成压力曲线,计算压力曲线的上升斜率,比较输卵管不同通畅程度时压力曲线上升斜率的差异。结果不同通畅程度的三组患者压力曲线上升斜率分别是:双侧通畅组(71例,52.21%)(1.242±0.572)kpa/s、一侧通畅组(一侧通畅、另一侧通而不畅或不通,45例,33.09%)(1.472±0.638)kpa/s、双侧阳性组(双侧均为通而不畅和/或不通,20例,14.71%)(2.068±1.236)kpa/s。压力曲线上升斜率与通畅程度之间有一定相关度(R=0.287,P<0.05)。双侧通畅组和双侧阳性组、一侧通畅组和双侧阳性组之间压力曲线上升斜率的差异均有统计学意义(P=0.001,P=0.012),而双侧通畅组和一侧通畅组之间压力曲线上升斜率的差异无统计学意义(P>0.05)。结论子宫输卵管超声造影检查中超声对比剂的推注压力曲线上升斜率与输卵管通畅性有一定相关性,可作为评估输卵管通畅性的客观指标之一。

Objective To explore the association between the slope of the rising pressure curve of ultrasound contrast agent and the tubal patency in transvaginal 4-dimensional hysterosalpingo-contrast sonography （ TVS 4D-HyCoSy）. Methods A total of 136 infertile patients underwent TVS 4D-HyCoSy using SonoVue as ultrasound contrast agent. The ultrasound contrast agent was injected and the pressure curve was recorded by the liquid injecting machine ,which can record the real-time injecting pressure and trace it into the pressure curve automatically. The slope of the rising pressure curve of injecting contrast agent was calculated and compared in different patency. Results The slopes of the rising pressure curve of ultrasound contrast agent in three groups which had different tubal patency status were： bilateral tubal patency group （71 cases, 52.21% ）1. 242 ± 0. 572 kpa/s, unilateral tubal patency group（one side patency, another side either passable or occlusion, 45 cases, 33.09% ） 1. 472 ± 0. 638 kpa/s and bilat- eral tubal lesion group （both sides passable or occlusion, 20 cases, 14.71% ） （2. 068±1. 236） kpa/s, separately. There was a certain correlation between the slope of the rising pressure curve and the tubal patency （ R = 0. 287, P 〈 0.05 ）. The slope of the rising pressure curve of injecting contrast agent in hystcrosalpingography had statistical differences between bilateral patcncy group and bilateral positive group, one side patency group and bilateral positive group （ P =0. 001, P =0.012）. While, it had no significant difference （ P 〉 0. 05 ） between bilateral patency group and one side patency group. Conclusion The slope of the rising pressure curve of injecting contrast agent in hysterosalpingography is associated with tubal patency, which can be used as one of the objective indexes when assessing the tubal patency.