四维子宫输卵管超声造影联合宫腔推注生理盐水对不孕女性宫腔病变的诊断价值

Diagnostic value of transvaginal four⁃dimensional hysterosalpingo⁃contrast sonography combined with salineinfusionsonography for uterine cavity lesions in infertile women

目的探讨经阴道四维子宫输卵管超声造影(transvaginal four-dimensional hysterosalpingo-contrast sonography,4D-HyCoSy)联合宫腔推注生理盐水(saline infusion sonography,SIS)对不孕女性宫腔病变的诊断价值。方法收集经阴道声诺维四维子宫输卵管超声造影的244例不孕女性患者为研究对象,所有患者在进行四维子宫输卵管超声造影后,均在超声引导下推注生理盐水宫腔造影。以宫腔镜病理检查结果为金标准,比较分析四维子宫输卵管超声造影(HyCoSy)和四维子宫输卵管超声造影联合宫腔推注生理盐水(HyCoSy+SIS)两种方法诊断宫腔病变的敏感性、特异性和准确率。结果 HyCoSy诊断宫腔病变的敏感性、特异性和准确率分别为68.8%、69.2%和68.8%,HyCoSy+SIS诊断宫腔病变的敏感性、特异性和准确率分别为92.2%、84.6%和91.8%,两者特异性差异无统计学意义(P> 0.05),敏感性、准确率差异有统计学意义(P <0.001)。结论 HyCoSy联合宫腔推注生理盐水造影可以清晰显示宫腔病变,尤其对内膜息肉、内膜息肉样增生及宫腔粘连的观察优于单纯HyCoSy造影,有助于提高宫腔微小病变的诊断准确率。

Objective The aim of this study was toinvestigate the diagnostic value of four⁃dimensional hysterosalpingo⁃contrast sonography(4D⁃HyCoSy)combined with saline infusion sonography(SIS)for uterine cavity lesions in infertile women.Methods The clinical data of 244 infertile women detected by transvaginal 4D⁃HyCoSy were analyzed.All the patients were performed with SIS guided by ultrasound after 4D⁃HyCoSy.The sensitivity,specificityand accuracy of HyCoSy and 4D⁃HyCoSy combined SIS for uterine cavity lesions in the diagnosis of uter⁃ine lesions were compared and analyzed.Results The sensitivity,specificityand accuracy of uterine cavity lesions diagnosed byHyCoSy were 68.8%,69.2%and 68.8%,respectively.While those by HyCoSy combined with SIS were 92.2%,84.6%and 91.8%,respectively.The difference in specificity was not statistically significant(P>0.05),while the difference in sensitivity and accuracy was statistically significant(P<0.001).Conclusions HyCoSy combined with SIS can clearly show uterine cavity lesions,and its diagnosis of small endometrial polyps,endome⁃trialhyperplasia and intrauterine adhesions are better than HyCoSy alone.HyCoSy combined with SIS canimprove diagnostic accuracy of uterine cavity lesions.