实时三维超声输卵管造影与X线造影诊断不孕症患者输卵管病变的价值比较

Comparison of the Value of Real time Three Dimensional Ultrasonography and Contrast Radiography for the Diagnosis of Tubal Disease in Patients with Infertility

目的:比较实时三维超声输卵管造影与X线造影检查诊断女性不孕症患者输卵管病变的临床应用价值。方法:选择2014年3月至2016年12月我院诊治的不孕症患者60例作为研究对象,所有患者都于月经干净后3-7 d同时随机实施实时三维超声输卵管造影与X线造影检查,观察并记录造影图像质量与诊断结果,比较两种方法的诊断效果。结果:实时三维超声输卵管造影与X线造影的图像质量优良率分别为98.3%和86.7%,实时三维超声输卵管造影的图像质量明显高于X线造影(P<0.05)。实时三维超声输卵管造影与X线造影诊断不孕症患者输卵管不通畅率分别为56.7%和46.7%,实时三维超声输卵管造影组显著高于X线造影组(P<0.05)。输卵管通畅性评价金标准腹腔镜下通液术诊断发现输卵管不通畅35例,在此基础上实时三维超声输卵管造影与X线造影检查不孕症的敏感性分别为97.1%和80.0%,特异性均为100.0%,超声诊断的敏感性明显高于X线(P<0.05)。结论:相对于X线造影,实时三维超声输卵管造影检查不孕症患者输卵管病变的图像质量更好,有利于疾病的判断,对输卵管通畅度判断更精确,利于后期治疗及疾病预防,还可提高诊断敏感性。

Objective： To compare the value of real time three dimensional ultrasonography and contrast radiography for the diagnosis of tubal disease in patients with infertility. Methods： From March 2014 to December 2016, 60 cases of infertility patients in our hospital were selected as the research object, all patients in menstrual clean alter 3-7d and the implementation of real time three dimensional ultrasonography and contrast radiography, the image quality and diagnosis results were recorded. The diagnostic effects of the two methods were compared. Results： The excellent and good rate of real time three dimensional ultrasonography and contrast radiography were 98.3% and 86.7% respectively, and the quality of real time three dimensional ultrasonography was significantly higher than that of contrast radiography （P〈0.05）. Real time three dimensional ultrasonography and contrast ultrasonography in the diagnosis of tubal infertility were 56.7% and 46.7%, respectively, which was higher in the real time three dimensional ultrasonography group than that of the contrast radiography （P〈0.05）. 35 cases were found in 60 cases of patients with laparoscopic diagnosis of tubal obstruction, the sensitivity of real time three dimensional ultrasonography and contrast radiography of tubal infertility were 97.1% and 80%, the specificity were 100%, the sensitivity of ultrasound diagnosis was significantly higher than that of the contrast radiography （P〈0.05）. Conclusion： Compared with the contrast radiography, real-time three-dimensional ultrasound contrast has better image quality for the tubal disease in patients with infertility, it has more accurate for tubal patency judgment, so as to improve the diagnostic sensitivity.