子宫输卵管超声造影联合宫腔水造影对宫腔病变的诊断价值

Diagnosis value of Hysterosalping constrast sonography combined with Saline solution infution sonohysterography on uterine cavity lesions

目的将经阴道实时三维子宫输卵管超声造影(TVS RT 3D-HyCoSy)与宫腔水造影(SIS)联合应用,旨在探讨两种造影联合应用对不孕症患者宫腔病变的诊断价值,为临床不孕症病因诊断提供更全面客观的依据。方法选择2016年1月至2017年12月在我院拟行宫腹腔镜手术的66例不孕症患者,术前行TVS RT 3D-HyCoSy联合SIS,根据宫腔镜检查(HS)结果分为宫腔病变组和无宫腔病变组,比较TVS RT 3D-HyCoSy联合SIS和TVS RT 3D-HyCoSy两种方法对宫腔病变的诊断敏感度、特异度、准确率、Kappa值,分析两种方法的诊断效能。结果以HS为标准,TVS RT 3DHyCoSy联合SIS诊断宫腔病变的灵敏度89.65%、特异度97.29%、准确率93.93%;TVS RT 3D-HyCoSy诊断宫腔病变的灵敏度48.27%、特异度89.18%、准确率71.21%;两种方法的特异度差异无统计学意义(P>0.05),灵敏度、准确率差异有统计学意义(P<0.05)。结论 TVS RT 3D-HyCoSy联合SIS可以提高宫腔病变的诊断准确性。

Objective To assess the diagnosis value of transvaginal ultrasound real time three-dimensional hysterosalping constrast sonography（TVS RT 3 D-HyCoSy）combined with saline solution infution sonohysterography（SIS）on uterine cavity lesions in patients with infertility,providing a more comprehensive and objective diagnosis of the cause of infertility.Methods The 66 patients with infertility were detected by TVS RT 3 D-HyCoSy combined with SIS in Fujian Provincial Hospital from January 2016 to December 2017,who would be operated for both Hysteroscopy（HS）and Laparoscopic surgery（LPS）.66 Patients of TVS RT 3 D-HyCoSy combined with SIS were divided into two groups：uterine cavity lesions and no uterine cavity lesions.According to hysteroscopy（HS）,we compared the results of TVS RT 3 D-HyCoSy and TVS RT 3 D-HyCoSy combined with SIS in the diagnosis of uterine cavity lesions and analyzed the diagnostic efficacy of the two methods.Results Compare the two methods of TVS RT 3 D-HyCoSy with SIS and TVS RT-3 D-HyCoSy in diagnosing uterine cavity lesions taking HS as the gold standard.The sensitivity,specificity and acurracy of TVS RT-3 D-HyCoSy combined with SIS diagnosing uterine cavity lesions were 89.65%,97.29%,93.93%.The sensitivity,specificity and acurracy of TVS RT-3 D-HyCoSy diagnosing uterine cavity lesions were 48.27%,89.18%,71.21%.The specificity difference between the two methods was no significant（P〉0.05）.The sensitivity and accuracy difference between the two methods were statistically significant（P〈0.05）.Conclusion TVS RT 3 D-HyCoSy combined with SIS could improve the accuracy of diagnosis in uterine cavity lesions.