经阴道二维和实时三维超声造影评价输卵管通畅性的价值

Value of transvaginal two-dimensional and real-time three-dimensional contrast-enhanced ultrasound in evaluating tubal patency

目的:对比分析经阴道二维和实时三维超声造影两种检查,探讨三维超声造影在诊断输卵管通畅性上的价值。方法:选取我院2017年12月至2018年10月收治的114例原发性不孕患者作为研究对象,采用经阴道实时三维输卵管超声造影(3D-HyCoSy)检查和经阴道二维输卵管超声造影(2D-HyCoSy)检查。比较两种模式造影检查时间、造影剂使用剂量及输卵管显示情况。结果:三维模式的造影检查时间明显短于二维模式,且造影剂使用剂量少于后者,差异均有统计学意义(P<0.05);输卵管远端显示率三维模式明显高于二维模式,差异有统计学意义(P<0.05);输卵管近端显示率三维模式与二维模式比较,差异无统计学意义(P>0.05)。结论:相较2D-HyCoSy,3D-HyCoSy可完整清晰显示造影剂从宫腔流入输卵管至伞端喷出这一系列过程,更具优势;对因条件所限仅能开展2D-HyCoSy单位,需关注检查对于操作者的依赖性以及输卵管远端阻塞的假阳性率,避免误诊。

Objective:To investigate the value of real-time three-dimensional hysterosalpingo-contrast-sonography(3 D-HyCoSy)in the diagnosis of tubal patency compared with transvaginal two-dimensional hysterosalpingocontrast-sonography(2 D-HyCoSy).Methods:From December 2017 to October 2018,114 patients with primary infertility were examined by transvaginal real-time 3 D-HyCoSy and 2 D-HyCoSy.The time of contrast examination,the dose of contrast medium and the display of fallopian tube were compared between the two g contrast-enhanced ultrasonography models of fallopian tube.Results:The contrast examination time of the three-dimensional model was significantly shorter than that of the two-dimensional model,and the contrast agent dosage of the threedimensional model was less than that of the two-dimensional model(P<0.05).The distal tubal display rate of the three-dimensional model was significantly higher than that of the two-dimensional model(P<0.05).There was no significant difference in the proximal tubal display rate between the three-dimensional model and the twodimensional model(P>0.05).Conclusion:Compared with 2 D-HyCoSy,3 D-HyCoSy can clearly show the contrast agent’s flow from the uterine cavity into the fallopian tube and the end of the umbrella,which is more advantageous.For some institutions where only 2 D-Hy Co Sy can be carried out,attention should be paid to checking the operator’s dependence skill and false positive rate of distal obstruction of the fallopian tubes to avoid misdiagnosis.