宫腔压力测定在四维超声造影中对输卵管通畅程度的评价效果

Evaluation of tubal patency by intrauterine pressure measurement in 4D contrast-enhanced ultrasound

目的研究宫腔压力测定在四维子宫输卵管超声造影(4D-HyCoSy)中对输卵管通畅程度的评价效果。方法采用回顾性分析方法,研究对象为2018年1月至2019年12月衡水市人民医院收治的100例不孕症患者,所有患者均接受4D-HyCoSy检查,比较输卵管不同通畅程度患者的宫腔压力值;采用受试者工作特征(ROC)曲线对宫腔压力联合4D-HyCoSy鉴别输卵管通畅程度的价值进行分析。结果输卵管通畅程度诊断中4D-HyCoSy的总符合率为82.00%;较其他通畅类型,双侧通畅输卵管宫腔压力峰值明显更低,差异有统计学意义(P<0.05);较其他通畅类型,双侧阻塞输卵管宫腔压力峰值明显更高,差异有统计学意义(P<0.05);宫腔压力诊断双侧阻塞与一侧通而不畅一侧阻塞、双侧不完全通畅与一侧通而不畅一侧阻塞、双侧通畅与双侧不完全通畅的截断值、曲线下面积(AUC)值依次为47.78 kPa、0.900,38.42 kPa、0.831和29.71 kPa、0.813。宫腔压力联合4D-HyCoSy诊断输卵管通畅程度的总符合率为95.00%,相较于单一4D-HyCoSy诊断符合率更高,差异有统计学意义(P<0.05)。结论宫腔压力测定在四维超声造影中的应用可有效提升输卵管通畅程度诊断的准确性,可为输卵管不孕的诊治提供参考依据。

Objective To study the effect of uterine pressure measurement on the evaluation of fallopian tube patency in four-dimensional hysterosalpingo-contrast sonography(4D-HyCoSy).Methods Retrospective analysis method was adopted to study 100 infertility patients admitted to Hengshui People’s Hospital from January 2018 to December 2019.All patients received 4D-Hyco SY examination,the uterine pressure values of patients with different degrees of oviduct patency were compared.Receiver operating characteristic curve(ROC)was selected to analyze the value of intrauterine pressure combined with 4D-HyCoSy in differentiating the degree of oviduct patency.Results The total coincidence rate of 4D-HyCoSy in the diagnosis of fallopian tube patency was 82.00%.Compared with other patency types,the peak pressure of uterine cavity was significantly lower on both sides(P<0.05).Compared with other unobstructed types,the intrauterine pressure peak of bilateral obstruction of fallopian tube was significantly higher(P<0.05).In the diagnosis of uterine pressure,the cut-off values and AUC values of bilateral obstruction and unilateral obstruction without smooth obstruction,bilateral incomplete patency and unilateral obstruction without smooth obstruction,bilateral patency and bilateral incomplete patency were(47.78 kPa,0.900),(38.42 kPa,0.831),(29.71 kPa,0.813).In the diagnosis of fallopian tube patency,the total coincidence rate of uterine pressure combined with 4D-HyCoSy was 95.00%,which was significantly higher than that of single 4D-HyCoSy diagnosis,and the difference was significant(P<0.05).Conclusion The application of intrauterine pressure measurement in four-dimensional contrast-enhanced ultrasound can effectively improve the accuracy of the diagnosis of tubal patency,and provide a reference for the diagnosis and treatment of tubal infertility.