经阴道四维子宫输卵管超声造影误诊原因分析

Analysis of misdiagnosis causes of transvaginal four-dimensional hysterosalpingography

目的通过对经阴道四维子宫输卵管超声造影(4D-HyCoSy)误诊病例进行分析,提高超声医师对输卵管造影的诊断。方法选择不孕不育患者67例,均给予4D-HyCoSy及腹腔镜美蓝通液术检查,检查输卵管134条。腹腔镜美蓝通液术检查结果作为判断输卵管通畅的金标准,将输卵管情况评为不通、通而不畅、通畅,并计算4D-HyCoSy诊断的误诊率及符合率。结果输卵管不通的符合率为94%,通而不畅的符合率为75%,诊断输卵管通畅的符合率为94%,4D-HyCoSy诊断输卵管通畅性的整体符合率为92.5%。结论经阴道四维子宫输卵管超声造影与腹腔镜通液术具有较高的符合率,但也有一定的误诊,误诊的主要原因分别为盆腔炎症、疼痛、逆流、卵巢及子宫位置影响等。

Objective To improve the diagnosis of transvaginal four-dimensional hysterosalpingography(4D-HyCoSy)by analyzing the misdiagnosis cases of transvaginal four-dimensional hysterosalpingography.Methods Sixty-seven patients with infertility were selected and examined by 4D-HyCoSy and laparoscopic methylene blue hydrotubation.134 fallopian tubes were examined.The results of the laparoscopic methylene blue hydrotubation were used as the gold standard to judge the patency of fallopian tubes.The condition of fallopian tubes was rated as obstruction,partial obstruction,and unobstruction.The misdiagnosis rate and coincidence rate of 4D-HyCoSy diagnosis were calculated.Results The coincidence rate of obstruction was 94%,the coincidence rate of partial obstruction was 75%,the coincidence rate of unobstruction was 94%,the overall coincidence rate of 4D-HyCoSy in the diagnosis of tubal patency was 92.5%.Conclusion The coincidence rate between transvaginal four-dimensional hysterosalpingography and laparoscopic hydrotubation is high,but there are also some misdiagnosis cases.The main causes of misdiagnosis are pelvic inflammation,pain,reflux,ovary and uterus location.