子宫输卵管实时三维超声造影与腹腔镜通染液检查评价输卵管通畅性的对比研究-现代医学

子宫输卵管实时三维超声造影与腹腔镜通染液检查评价输卵管通畅性的对比研究

单位：1. 无锡市锡山人民医院超声科, 江苏无锡 214011;
2. 无锡市锡山人民医院妇科, 江苏无锡 214011;
3. 扬州大学附属医院超声科, 江苏扬州 225001

分类号：R711.61

出版年·卷·期（页码）：2018·46·第五期（541-545）

摘要：

目的：探讨子宫输卵管实时三维超声造影评价输卵管通畅性的临床效果和应用价值。方法：选择2015年6月至2017年10月在无锡市锡山人民医院治疗的54例不孕症患者，分别进行子宫输卵管实时三维超声造影和腹腔镜通染液检查，分析两种检查方法符合率、敏感度和特异度。结果：54例患者共有输卵管102条（其中6例患者有单侧输卵管切除病史）。实时三维超声造影结果显示输卵管有21条通畅，34条通而不畅，47条阻塞。行腹腔镜下通染液检查结果显示输卵管有19条通畅，32条通而不畅，51条阻塞。采用腹腔镜下通染液检查的结果为判断标准，子宫输卵管实时三维超声造影在输卵管通畅性诊断中的敏感性和特异性分别为91.84%和96.08%，阳性预测值和阴性预测值分别为95.74%和89.09%。102条输卵管实时三维超声造影与腹腔镜通染液检查的结果具有较高的吻合度（Kappa=0.843 2，P<0.05）。结论：子宫输卵管实时三维超声造影与腹腔镜通染液检查在不孕症患者中应用于输卵管通畅性的诊断结果一致性较好，是一种临床诊断不孕症切实可行的方法。

Objective: Using real-time three-dimensional Hysterosalpingo-contrast sonography(3D-HyCoSy) and laparoscopy examination to compare and study the patency of fallopian tube and to explore the clinical effect and application value for tubal patency evaluation.Methods: A total of 54 infertile patients treated in our hospital from June 2015 to October 2017 were selected. All of them took real-time 3D-HyCoSy and laparoscopy examination. The diagnostic coincidence rate, sensitivity and specificity were compared between the two groups.Results: For all 102 fallopian tubes in 54 patients(6 patients had a history of unilateral salpingectomy), real-time 3D-HyCoSy showed 21 unobstructed tubes, 34 partially passable and 47 obstructed tubes, while laparoscopy examination showed 19 unobstructed tubes, 32 partially passable and 51 obstructed tubes. The results of laparoscopic examination was taken asthe judgment standard, the sensitivity, specificity of real-time 3D-HyCoSy for diagnosis of fallopian tubal patency was 91.84%,96.08%, while positive predictive value and negative predictive value was 95.74%,89.09%.102 fallopian tubes were checked by both real-time 3D-HyCoSy and laparoscopy. The results show that the two methods had a good consistency(Kappa=0.843 2, P <0.05).Conclusion: Real-time 3D-HyCoSy and laparoscopy have good consistency in assessing fallopian tube patency for infertile female patients, which is a feasible method of clinical diagnosis for infertility.

参考文献：

[1] 陈粉红,黄品同,陈伟.子宫输卵管动态三维超声造影在不孕症诊断中的应用价值[J].中国超声医学杂志,2015,31(9):810-812.
[2] 李醒,桑鋆智,王东旭.三维子宫输卵管超声造影与X线子宫输卵管造影对输卵管通畅性诊断的比较研究[J].齐齐哈尔医学院学报,2016,37(6):765-766.
[3] 廖建梅,杨舒萍,林彦銮,等.经阴道实时三维超声子宫输卵管造影与腹腔镜检查评价输卵管通畅性[J].中国超声医学杂志,2015,31(12):1117-1119.
[4] 陆小燕,刘爱玲.二维与三维超声造影诊断不孕症患者输卵管通畅性的临床应用分析[J].医学影像学杂志,2017,27(2):377-379.
[5] EXACOUSTOS C,ZUPI E,SZABOLCS B,et al.Contrast tuned imaging and second generation contrast agent SonoVue:anew ultrasound approach to evaluate tubal patency[J].Minim Invasive Gynecol,2009,16(4):437-444.
[6] 张玉,李蕊,李海燕,等.子宫输卵管动态三维超声造影在评估输卵管通畅性中的应用[J].中国超声医学杂志,2015,31(9):816-818.
[7] 黄惠益,李秀明,毕庶青.经阴道子宫输卵管实时三维超声造影评价女性不孕症患者输卵管通畅性的临床分析[J].广西医科大学学报,2017,34(4):588-590.
[8] HE Y,GENG Q,LIU H,et al.First experience using 4-dimensional hysterosalpingo-contrast sonography with SonoVue for assessing fallopian tube patency[J].J Ultrasound Med,2013,2(7):1233-1243.
[9] 王锦惠,门殿霞,于子芳,等.经阴道子宫输卵管动态三维超声造影评价输卵管通畅性的有效性和安全性[J].中国超声医学杂志,2015,31(11):1016-1019.
[10] 张玫玫,殷立平,强也.不孕症经阴道三维子宫输卵管超声造影与中医证型相关性分析——附60例临床资料[J].江苏中医药,2015,21(6):40-42.
[11] 李蕊,王琦,张红薇.实时三维子宫输卵管超声造影评价输卵管通畅性及其影响因素分析[J].医学影像学杂志,2015,25(1):127-130.
[12] 张姗,田力,毕蓓蕾.经阴道实时三维子宫输卵管超声造影评价输卵管通畅性的诊断价值[J].中国临床医学影像杂志,2016,27(12):892-895.
[13] 李宏波,殷立平,张玫玫,等.实时三维子宫输卵管超声造影耐受性和安全性评估[J].东南大学学报(医学版),2016,35(3):310-313.
[14] 吴敏萍,潘华,骆峰.子宫输卵管碘油造影与经阴道实时三维子宫输卵管超声造影的诊断价值[J].医学影像学杂志,2015,25(8):1500-1503.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录