经阴道二维和实时三维超声造影评价输卵管通畅性的价值-现代医学

经阴道二维和实时三维超声造影评价输卵管通畅性的价值

单位：南京中医药大学附属医院/江苏省中医院超声医学科, 江苏南京 210029

分类号：R445.1;R771.6

出版年·卷·期（页码）：2019·47·第八期（905-909）

摘要：

目的：对比分析经阴道二维和实时三维超声造影两种检查，探讨三维超声造影在诊断输卵管通畅性上的价值。方法：选取我院2017年12月至2018年10月收治的114例原发性不孕患者作为研究对象，采用经阴道实时三维输卵管超声造影（3D-HyCoSy）检查和经阴道二维输卵管超声造影（2D-HyCoSy）检查。比较两种模式造影检查时间、造影剂使用剂量及输卵管显示情况。结果：三维模式的造影检查时间明显短于二维模式，且造影剂使用剂量少于后者，差异均有统计学意义（P<0.05）；输卵管远端显示率三维模式明显高于二维模式，差异有统计学意义（P<0.05）；输卵管近端显示率三维模式与二维模式比较，差异无统计学意义（P>0.05）。结论：相较2D-HyCoSy，3D-HyCoSy可完整清晰显示造影剂从宫腔流入输卵管至伞端喷出这一系列过程，更具优势；对因条件所限仅能开展2D-HyCoSy单位，需关注检查对于操作者的依赖性以及输卵管远端阻塞的假阳性率，避免误诊。

Objective:To investigate the value of real-time three-dimensional hysterosalpingo-contrast-sonography (3D-HyCoSy)in the diagnosis of tubal patency compared with transvaginal two-dimensional hysterosalpingo-contrast-sonography (2D-HyCoSy). Methods:From December 2017 to October 2018, 114 patients with primary infertility wereexamined by transvaginal real-time 3D-HyCoSy and 2D-HyCoSy. The time of contrast examination, the dose of contrast medium and the display of fallopian tube were compared between the two g contrast-enhanced ultrasonography models of fallopian tube.Results:The contrast examination time of the three-dimensional model was significantly shorter than that of the two-dimensional model, and the contrast agent dosage of the three-dimensional model was less than that of the two-dimensional model (P<0.05). The distal tubal display rate of the three-dimensional model was significantly higher than that of the two-dimensional model (P<0.05). There was no significant difference in the proximal tubal display rate between the three-dimensional model and the two-dimensional model (P>0.05).Conclusion:Compared with 2D-HyCoSy, 3D-HyCoSy can clearly show the contrast agent's flow from the uterine cavity into the fallopian tube and the end of the umbrella, which is more advantageous. For some institutionswhere only 2D-HyCoSy can be carried out, attention should be paid to checking the operator's dependence skill and false positive rate of distal obstruction of the fallopian tubes to avoid misdiagnosis.

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