碘油子宫输卵管造影3种延迟摄片时间对比

Comparison ofComparison of three delayed radiographs with iodized oil hysterosalpingography three delayed radiographs with iodized oil

目的探究罂粟乙碘油子宫输卵管造影(HSG)2h、6h延迟片对输卵管通畅度和盆腔粘连的诊断价值。方法选择2022年8月~2023年8月就诊于徐州市中心医院接受罂粟乙碘油HSG的86例女性不孕症患者,年龄30.30±4.59岁,不孕时间2.12±2.45年,孕次1.26±1.50次,产次0.43±0.56次;其中14例患者有盆腔炎性疾病病史,6例患者有子宫内膜异位症病史,9例患者有阑尾炎病史,19例患者有输卵管妊娠病史,11例患者有剖宫产手术史,17例患者有其他盆腔手术史。嘱患者在碘油HSG术后6 h内步行超6000步,将碘油HSG术后2 h、6h延迟片与24 h延迟片相对比,采用Kappa检验评估其对输卵管通畅度和盆腔粘连诊断结果的一致性。以HSG术后24 h延迟片为参照,对2 h、6h延迟片诊断结果进行混淆矩阵分析,将曲线下面积(AUC)作为首要评估指标,结合精确率、准确率、敏感度、特异度、F1值评估2 h及6 h延迟片的诊断价值。结果2 h与24 h延迟片对输卵管通畅度诊断结果一致性中等(Kappa=0.599,P<0.001),诊断效能中等(AUC=0.836);6h与24h延迟片对输卵管通畅度诊断结果一致性较好(Kappa=0.934,P<0.001),诊断效能较高(AUC=0.979)。2h与24h延迟片对盆腔粘连程度诊断结果一致性较差(Kappa=0.374,P<0.001),诊断效能较低(AUC=0.670);6h与24h延迟片对盆腔粘连程度诊断结果一致性较好(Kappa=0.780,P<0.001),诊断效能中等(AUC=0.870)。结论当罂粟乙碘油HSG术后6 h内步行超6000步时,6h延迟片可以替代24 h延迟片进行输卵管通畅度及盆腔粘连程度的诊断,2h延迟片暂不能替代24h延迟片进行诊断。

Objective To examine the diagnostic value of delayed radiographs taken at 2 h and 6 h after performing ethiodized poppyseed oil hysterosalpingography(HSG)to assess tubal patency and pelvic adhesion.Methods A total of 86 female infertility patients,with an average age of 30.30±4.59 years,an average duration of infertility of 2.12±2.45 years,an average number of pregnancies of 1.26±1.50,and an average number of deliveries of 0.43±0.56,were chosen from those who underwent HSG with ethiodized poppyseed oil at Xuzhou Central Hospital from August 2022 to August 2023.Out of the patients in the study,14 had a history of pelvic inflammatory diseases,6 had a history of endometrial conditions,9 had a history of appendicitis,19 had a history of tubal pregnancy,11 had a history of caesarean delivery,and 17 had a history of other pelvic surgery.The patients were directed to walk a distance of at least 6000 steps within a time frame of 6 h following the HSG operation.The diagnostic consistency of tubal patency and pelvic adhesion was assessed by calculating Cohen's Kappa coefficient for the delayed radiographs taken at 2 h,6 h,and 24 h.A confusion matrix was generated to analyze the diagnostic findings of the 2 h and 6 h delayed radiographs compared to the 24 h delayed radiographs.The key evaluation metric utilized was the area under the curve(AUC),combined with accuracy,precision,sensitivity,specificity,and the F1-score,to assess the diagnostic value of delayed radiographs taken at 2 h and 6 h.Results The delayed radiographs taken at 2 h and 24 h intervals indicated a moderate level of consistency(Kappa=0.599,P<0.001)and a moderate capacity to diagnose tubal patency(AUC=0.836).The evaluations conducted at 6 h and 24 h intervals demonstrated a high level of consistency(Kappa=0.934,P<0.001)and excellent diagnostic capacity(AUC=0.979).In the case of pelvic adhesion,the intervals of 2 h and 24 h showed a low level of consistency(Kappa=0.374,P<0.001)and a lower ability to diagnose(AUC=0.670).On the other hand,the intervals of 6 h and 24 h demonstrated a high level of consistency(Kappa=0.780,P<0.001)and moderate diagnostic efficacy(AUC=0.870).Conclusion Patients who exceed 6000 steps within 6 h after receiving ethiodized poppyseed oil HSG can use the 6 h delayed radiographs instead of the 24 h delayed radiographs for diagnosing tubal patency and pelvic adhesion severity.However,the delayed radiographs taken at 2 h cannot adequately replace the delayed radiographs taken at 24 h in terms of diagnosing a condition.