二次谐波造影与X线造影检查诊断输卵管通畅性对比研究

Comparative study of second harmonic contrast and X-ray contrast in diagnosis of tubal patency

目的:探讨二次谐波造影与X线造影检查诊断输卵管通畅性的价值。方法:选取65例(共130条输卵管)不孕女性患者作为研究对象,均行X线输卵管造影与二次谐波造影检查,评价两种造影方法的诊断效能。结果:以腹腔镜检查结果为金标准,显示完全通畅44条,阻塞46条,通而不畅40条。二次谐波造影显示完全通畅44条,阻塞42条,通而不畅44条。X线造影显示完全通畅46条,阻塞40条,通而不畅44条,经对比发现二次谐波造影与腹腔镜检查结果更接近。X线造影评估输卵管通畅性的灵敏度为86.4%(38/44)、特异度为90.7%(78/86)、准确率为89.2%(116/130);二次谐波造影评估输卵管通畅性的灵敏度为90.9%(40/44)、特异度为95.3%(82/86)、准确率为93.8%(122/130),对比差异都均无统计学意义(均P>0.05)。经X线造影和二次谐波造影检查发现造影剂盆腔弥散情况与输卵管通畅度有关联性(P<0.05)。Kappa一致性分析显示X线造影、二次谐波造影与腹腔镜检查诊断输卵管通畅都具有高度一致性(P<0.05),且二次谐波造影一致性稍高于X线造影。结论:二次谐波造影、X线造影与腹腔镜检查诊断输卵管通畅具有很好的一致性,其能有效反映输卵管通畅情况,有很好的应用价值。

Objective:To explore the value of second harmonic contrast and X-ray contrast in the diagnosis of tubal patency.Methods:65 infertile female patients(130 fallopian tubes in total)were selected as the research objects.X-ray salpingography and second harmonic contrast were performed.The diagnostic efficacy of the two imaging methods was evaluated with the results of laparoscopy as the gold standard.Results:Taking the results of laparoscopy as the gold standard,44 were completely unobstructed,46 were blocked,and 40 were unobstructed.Second harmonic contrast showed that 44 were completely unobstructed,42 were blocked,and 44 were unobstructed.The results of X-ray angiography were 46 completely unobstructed,40 were blocked,and 44 were unobstructed.It was found that the results of second harmonic angiography were closer to those of laparoscopy.The sensitivity,specificity and accuracy of X-ray contrast in evaluating tubal patency were 86.4%(38/44),90.7%(78/86)and 89.2%(116/130).The sensitivity,specificity and accuracy of second harmonic contrast were 90.9%(40/44),95.3%(82/86)and 93.8%(122/130).There was no significant difference(all P>0.05).It was found that the pelvic diffusion of contrast medium was correlated with the patency of fallopian tube(P<0.05).Kappa consistency analysis showed that X-ray contrast,second harmonic contrast and laparoscopy were highly consistent in the diagnosis of tubal patency(all P<0.05),and the consistency of second harmonic contrast was slightly higher than that of X-ray contrast.Conclusion:Second harmonic contrast,X-ray contrast and laparoscopy have good consistency in the diagnosis of tubal patency,but the sensitivity,specificity and accuracy of second harmonic contrast are higher than X-ray contrast,and can effectively reflect the tubal patency and has a good application value.