经阴道四维子宫输卵管超声造影与腹腔镜检查诊断输卵管通畅一致性分析

The consistency of the diagnostic results of transvaginal four-dimensional hysterosalpingo contrast sonography and laparoscopy in diagnosis of tubal patency

目的分析经阴道四维子宫输卵管超声造影(4D-HyCoSy)与腹腔镜检查诊断输卵管通畅一致性并评价其应用价值。方法选择2018-08~2019-11该院接治的不孕症患者60例(共120条输卵管)作为研究对象。所有研究对象均接受经阴道4D-HyCoSy检查和腹腔镜检查对输卵管的通畅情况进行诊断,分析两种检查方法诊断结果的一致性。分析经阴道4D-HyCoSy检查过程中造影剂盆腔弥散及卵巢包绕情况与输卵管通畅度的关联性。结果腹腔镜检查显示输卵管通畅55条,通而不畅37条,阻塞28条;经阴道4D-HyCoSy检查结果显示输卵管通畅58条,通而不畅35条,阻塞27条。两种方法检查结果具有高度一致性(Kappa=0.908,P=0.000)。输卵管通畅者,盆腔造影剂多呈均匀弥散(82.76%),以环状包绕卵巢为主(91.38%);输卵管通而不畅者,盆腔造影剂多呈不均匀弥散(88.57%),以半环状包绕卵巢为主(88.57%);输卵管阻塞者,盆腔造影剂呈无弥散(100.00%),以无包绕卵巢为主(92.59%)。经阴道4D-HyCoSy检查过程中造影剂盆腔弥散及卵巢包绕情况与输卵管通畅度具有关联性(P<0.05)。结论经阴道4D-HyCoSy检查与腹腔镜下通染液检查在输卵管通畅情况评判方面具有高度一致性,具有较高的临床应用价值。

Objective To analyze the consistency of the diagnostic results of transvaginal four-dimensional hysterosalpingo contrast sonography(4D-HyCoSy)and laparoscopy in diagnosis of tubal patency,and to investigate the application value of 4D-HyCoSy in the evaluation of tubal patency.Methods Sixty infertile patients(120 fallopian tubes)treated in our hospital from August 2018 to November 2019 were selected as the research subjects.All the subjects underwent transvaginal 4D-HyCoSy and laparoscopy to diagnose tubal patency and the consistency of the diagnostic results of the two methods was analyzed.The correlation between the pelvic diffusion of contrast media and ovarian wrapping and the patency of fallopian tubes during 4D-HyCoSy examination was analyzed.Results Laparoscopic examination showed that there were 55 unobstructed tubes,37 partially obstructed tubes and 28 completely obstructed tubes.The results of 4D-HyCoSy examination showed that there were 58 unobstructed tubes,35 partially obstructed tubes and 27 completely obstructed tubes.The results of the two methods were highly consistent(Kappa=0.908,P=0.000).For the patients with tubal patency,most of the pelvic contrast media were evenly diffused(82.76%),and the ring-shaped wrapped ovaries were the main parts(91.38%).For those with partially obstructed tubes,most of the pelvic contrast media were unevenly diffused(88.57%),and the semicircle-shaped wrapped ovaries were the main parts(88.57%).For those with completely obstructed tubes,the pelvic contrast media were not diffused(100.00%),and non-wrapped ovaries were the main parts(92.59%).There was a correlation between the pelvic diffusion of contrast media and the condition of ovarian wrapping and the patency of fallopian tubes during transvaginal 4D-HyCoSy examinations(P<0.05).Conclusion The transvaginal 4D-HyCoSy examination and the laparoscopy fluid examination have a high consistency in the evaluation of the patency of fallopian tubes,and have a high clinical application value.