全氟显子宫输卵管四维超声造影评价不孕女性输卵管通畅性

Four-dimensional hysterosalpingo-contrast sonography with fluorocarbon in evaluation on fallopian tube patency in infertile women

目的探讨全氟显子宫输卵管四维超声造影(4D-HyCoSy)评估不孕女性输卵管通畅性的应用价值。方法对138例不孕女性患者分别行4D-HyCoSy和X线子宫输卵管造影(X-HSG)检查。以腹腔镜结果为诊断金标准,对比分析4D-HyCoSy与X-HSG诊断输卵管通畅、通而不畅及阻塞的特异度及敏感度的差异。结果 4D-HyCoSy诊断输卵管通畅的特异度96.32%(157/163)、敏感度95.33%(102/107),通而不畅的特异度97.75%(174/178)、敏感度93.48%(86/92),阻塞的特异度96.98%(193/199)、敏感度92.96%(66/71)。X-HSG诊断输卵管通畅的特异度92.02%(150/163)、敏感度92.52%(99/107),通而不畅的特异度95.51%(170/178)、敏感度86.96%(80/92),阻塞的特异度96.98%(193/199)、敏感度90.14%(64/71)。4D-HyCoSy与X-HSG诊断输卵管通畅、通而不畅及阻塞的特异度及敏感度差异均无统计学意义(P均>0.05),且两种方法诊断结果的一致性较好(Kappa=0.887)。结论全氟显4D-HyCoSy可有效评价输卵管通畅性,有助于诊断及治疗女性不孕症。

Objective To explore the application value of four-dimensional hysterosalpingo-contrast sonography (4DHyCoSy)with fluorocarbon in evaluation on fallopian tube patency in infertile women.Methods 4D-HyCoSy and X-ray hysterosalpingography (X-HSG)were performed in 138 infertile women.Taken the results of laparoscopy as gold standards,the diagnostic specificity and sensitivity of oviducts unobstructed,partially unobstructed and obstructed were compared between 4D-HyCoSy and X-HSG.Results The diagnostic specificity and sensitivity of oviducts unobstructed with 4D-HyCoSy was 96.32% (157/163)and 95.33% (102/107),of partially unobstructed was 97.75% (174/178)and93.48% (86/92),while of obstructed was 96.98% (193/199)and 92.96% (66/71).The diagnostic specificity and sensitivity of oviducts unobstructed with X-HSG was 92.02% (150/163)and 92.52% (99/107),of partially unobstructed was 95.51% (170/178)and 86.96% (80/92),while of obstructed was 96.98% (193/199)and 90.14% (64/71).There was no significant difference of diagnostic specificity nor sensitivity of oviducts unobstructed,partially unobstructed and obstructed between 4D-HyCoSy and X-HSG (all P>0.05),and the consistency of 4 D-HyCoSy and X-ray in diagnosis of fallopian tube patency was good (Kappa=0.887).Conclusion 4D-HyCoSy with fluorocarbon can be used to evaluate the fallopian tube patency,therefore being helpful to diagnosis and treatment of infertility.