经阴道子宫输卵管实时三维超声造影与X线碘油造影术对女性不孕症的诊断价值

Diagnostic value of real-time three-dimensional ultrasound contrast-enhanced hysterosalpingography and X-ray lipiodol contrast-enhanced hysterosalpingography in female infertility

目的:探讨经阴道子宫输卵管实时三维超声造影(RT-3D-HyCoSy)与X线碘油造影术(HSG)对女性不孕症的诊断价值。方法:选取70例(140条输卵管)不孕症患者为研究对象,按照影像学检查方式不同分为对照组和观察组,每组各35例。对照组患者行HSG检查;观察组患者行RT-3D-HyCoS检查,并于检查后次月月经干净后3~7 d行腹腔镜输卵管通液术(CLP)。比较两种影像学检查方法与CLP检查结果的符合率;以CLP检查结果为“金标准”,分析HSG与3D-HyCoSy检查对不孕症的诊断价值。结果:HSG和RT-3D-HyCoSy检查与CLP结果相符合的输卵管条数分别为52条和65条,两种检查方式与CLP的符合率比较,差异有统计学意义(74.29%vs.92.86%,χ^(2)=8.792,P=0.003)。以CLP检查结果为“金标准”,RT-3D-HyCoSy检查的敏感性、阴性预测值及准确性高于HSG检查(P<0.05);两种检查的特异性、阳性预测值比较,差异无统计学意义(P>0.05)。结论:相较传统HSG,RT-3D-HyCoSy是诊断女性不孕症更有效的方法,值得临床推广。

Objective:To explore the diagnostic value of transvaginal real-time three-dimensional hysterosalpingo-contrast sonography(RT-3D-HyCoSy)and X-ray lipiodol contrast-enhanced hysterosalpingography(HSG)in infertility.Methods:A total of 70 patients(140 fallopian tubes)with infertility were selected as the research objects,and they were divided into control group and observation group according to different imaging examination methods,with 35 cases in each group.The control group was examined by HSG,and the observation group was examined by RT-3D-HyCoSy.After imaging examination,Laparoscopic dye test(CLP)was performed 3~7 days after menstruation was cleared the following month.The coincidence rate between the two imaging methods and the results of CLP examination was evaluated.The diagnostic value of HSG and 3D-HyCoSy in infertile women were evaluated by using CLP results as the‘gold standard’.Results:The number of fallopian tubes consistent with the results of HSG examination and CLP examination was 52(74.29%),and the number of fallopian tubes consistent with the results of RT-3D-HyCoSy and CLP examination was 65(92.86%).There was a statistically significant difference in the coincidence rate between the two methods and CLP(χ^(2)=8.792,P=0.003).Taking the results of CLP as the‘gold standard’,the sensitivity,negative predictive value and accuracy of RT-3D-HyCoSy were higher than those of HSG(P<0.05),the difference in specificity and positive predictive value between the two groups was not statistically significant(P>0.05).Conclusion:RT-3D-HyCoSy is an effective method for the diagnosis of tubal patency in infertile women.It has more advantages than traditional HSG and is worthy of clinical promotion.