MR-HSG对输卵管通畅度的评判探讨

Evaluation of fallopian tube patency by megnetic resonance hysterosalpingography

目的探讨MR-HSG对输卵管通畅程度的评价能力。方法选取80例女性不孕症患者行MR-HSG,根据输卵管形态、对比剂弥散时间、注射压力及患者疼痛等情况,判断输卵管通畅、不完全梗阻及阻塞,通过输卵管介入再通术和宫腹腔镜联合手术计算输卵管阻塞病例中的假阳性率。结果1例患者操作失败,79例操作成功病例中显示55例双侧输卵管通畅,1例单角子宫伴同侧输卵管通畅,对侧缺如;9例一侧输卵管通畅,对侧不完全梗阻;5例双侧输卵管不完全梗阻;7例一侧输卵管不完全梗阻,对侧阻塞;2例双侧输卵管阻塞。9例共11根输卵管阻塞患者行输卵管介入再通术或宫腹腔镜联合手术,有3根输卵管手术证实通畅,假阳性率约27%。结论MR-HSG能判断输卵管的通畅程度,可为临床提供可靠的影像学依据。

Objective To explore the ability of MR-HSG to evaluate the patency of fallopian tube.Methods 80 female infertility patients were selected for MR-HSG.According to the shape of fallopian tube,the diffusion time of the contrast agent at the umbrella end of the fallopian tube,the injection pressure of the contrast agent in the uterine cavity and the pain of the patients,the patency of the fallopian tube,the incomplete obstruction of the fallopian tube and the obstruction of the fallopian tube were judged.Results In one case,the operation failed.In 79 successful cases,55 bilateral fallopian tubes were unobstructed,1 single angle uterus with one side fallopian tube unobstructed and the other side fallopian tube was absent;one side fallopian tube in 9 cases unobstructed and the other side fallopian tube incompletely obstructed;two sides fallopian tube in 5 cases incompletely obstructed;one side fallopian tube in 7 cases incompletely obstructed and the other side fallopian tube obstructed;2 sides of fallopian tube obstructed.Nine patients with 11 tubal obstruction underwent tubal interventional recanalization or hysteroscopic surgery.Three of them were proved to be unobstructed,and the false positive rate was about 27%.Conclusion MR-HSG can judge the patency of fallopian tube and provide reliable imaging basis for clinical practice.