对比分析螺旋CT仿真子宫输卵管造影与经阴道四维子宫输卵管造影术在女性不孕症诊断中的价值

Comparative analysis of spiral CT simulated hysterosalpingography and transvaginal four-dimensional hysterosalpingography in the diagnosis of female infertility

目的 对比分析螺旋CT仿真子宫输卵管造影与经阴道四维子宫输卵管造影术在女性不孕症诊断中的价值。方法 回顾性选取2019年7月至2022年7月西安高新医院收治的疑似女性不孕患者62例为研究对象,所有患者均进行四维子宫输卵管造影和螺旋CT仿真子宫输卵管造影,以腔镜亚甲蓝通液判断输卵管通畅结果为金标准,对比两种检查方式对于输卵管的通畅性,采用受试者工作特征(ROC)曲线分析四维子宫输卵管造影以及螺旋CT仿真子宫输卵管造影在女性不孕症中的诊断价值。结果 螺旋CT仿真子宫输卵管造影患者输卵管通畅性和腔镜亚甲蓝通液判断输卵管通畅结果的一致性极强,Kappa值为0.538;四维子宫输卵管造影患者输卵管通畅性和腔镜亚甲蓝通液判断输卵管通畅结果的一致性良好,Kappa值为0.432,螺旋CT仿真子宫输卵管造影患者输卵管通畅性的结果优于四维子宫输卵管造影,差异有统计学意义(P<0.05)。经一致性分析证实,螺旋CT仿真子宫输卵管造影评估女性不孕症的敏感度为96.55%,特异度为87.88%,准确率为91.94%,阳性预测值为97.50%,阴性预测值为96.67%,Kappa值为0.839。经一致性分析证实,四维子宫输卵管造影评估女性不孕症的敏感度为79.31%,特异度为69.70%,准确率为74.19%,阳性预测值为69.70%,阴性预测值为79.31%,Kappa值为0.486;经一致性分析证实,螺旋CT仿真子宫输卵管造影评估女性不孕症的敏感度和准确度更高。ROC曲线分析结果显示,螺旋CT仿真子宫输卵管造影对女性不孕症的鉴别诊断价值优于四维子宫输卵管造影。结论 相较于四维子宫输卵管造影,螺旋CT仿真子宫输卵管造影对女性不孕症的诊断价值更高,临床可优先选用此种方法对女性不孕症进行诊断。

Objective To compare and analyze the spiral CT simulated hysterosalpingography and transvaginal four-dimensional hysterosalpingography in the diagnosis of female infertility.Methods Sixty-two patients with suspected female infertility admitted to Xi'an Gaoxin Hospital from July 2019 to July 2022 were retrospectively selected for the study,and all patients underwent 4-dimensional hysterosalpingography and spiral CT simulated hysterosalpingography,with lumpectomy methylene blue lavage to determine tubal patency results as the gold standard,the patency of the two examination modalities for tubal patency were compared,and the diagnostic value of 4-dimensional hysterosalpingography and spiral CT simulated hysterosalpingography in female infertility were analyzed by receiver operating characteristic(ROC)curve.Results The consistency of tubal patency between spiral CT simulation hysterosalpingography and luminal methylene blue fluids was excellent,with a Kappa value of 0.538;the consistency of tubal patency between 4-dimensional hysterosalpingography and luminal methylene blue fluids was good,with a Kappa value of 0.432.The results of patency were better than those of 4-dimensional hysterosalpingography,the difference was statistically significant(P<0.05).The sensitivity of spiral CT simulated hysterosalpingography for the assessment of female infertility was confirmed by consistency analysis to be 96.55%,specificity 87.88%,accuracy 91.94%,positive predictive value 97.50%,negative predictive value 96.67%,and kappa value 0.839.The sensitivity of 4-dimensional hysterosalpingography for assessing female infertility was 79.31%,specificity was 69.70%,accuracy was 74.19%,positive predictive value was 69.70%,negative predictive value was 79.31%,and kappa value was 0.486 as confirmed by consistency analysis;consistency analysis confirms greater sensitivity and accuracy of spiral CT simulated hysterosalpingography in the assessment of female infertility.The ROC curve analysis results shoued that spiral CT simulated hysterosalpingography has better differential diagnostic value than four-dimensional hysterosalpingography for female infertility.Conclusion Compared to four-dimensional hysterosalpingography,spiral CT simulated hysterosalpingography has higher differential diagnostic value for female infertility,this method can be prioritized in clinical diagnosis of female infertility.