摘要
目的探讨经阴道三维超声造影容积重建(3D HyCoSy)技术评价女性不孕患者输卵管通畅性的应用价值。方法连续纳入疑似输卵管阻塞的不孕患者92例,行经阴道3DHyCoSy检查。对25例患者于造影前后2周内行腹腔镜亚甲蓝通液术或碘油造影,将经阴道3D HyCoSy检查结果与之进行比较。结果 92例患者共检查183条输卵管,经阴道3DHyCoSy清晰显示177条(177/183,96.72%)。183条输卵管中,75条通畅(75/183,40.98%),53条通而不畅(53/183,28.96%),55条阻塞(55/183,30.05%);33条输卵管伞端粘连(33/183,18.03%),6例子宫肌层损伤,4例宫颈机能不良。对输卵管通而不畅患者随访6～12个月,期间20例怀孕(20/36,55.56%)。3D HyCoSy诊断输卵管阻塞的敏感度为86.21%(25/29),特异度90.00%(18/20),阳性预测值92.59%(25/27),阴性预测值81.82%(18/22),阳性似然比8.62,阴性似然比0.16。结论利用经阴道3D HyCoSy可清晰直观、准确地评价输卵管的通畅性,并对输卵管通而不畅具有一定治疗作用,操作简单,安全可靠,可在临床推广应用。
Objective To explore the value of three-dimensional hysterosal-pingo-contrast sonography （3D HyCoSy） in evaluation on the patency of fallopian tube in infertile women. Methods Ninety-two infertile women with suspected tubal obstruction were collected, 3D HyCoSy examination was performed. Twenty-five patients underwent laparoscopic meilan pass liquid technique or iodine oil imaging within 2 weeks of 3D HyCoSy, and the results were compared. Results Totally 183 fallopian tubes were checked in 92 patients, and 177（177/183, 96.72%） were shown clearly by 3D HyCoSy. There were 75 （75/183, 40.98%） tubes with good patency, 53 （53/183, 28.96%） with incomplete obstruction and 55 （55/183, 30.05%） with complete obstruction. Umbrella end adhesion was detected in 33 （33/183, 18.03%） tubes, uterine muscle injury was found in 6 patients, while cervical dysfunction was noticed in 4 patients. During the following-up of 6—12 months for patients with incomplete obstruction of fallopian tubes, pregnancy occurred in 20 （20/36, 55.56%） patients. The sensitivity, specificity, positive predictive value and negative predictive value of 3D HyCoSy for evaluation of tubal obstruction was 86.21% （25/29）, 90.00% （18/20）, 92.59% （25/27）and 81.82% （18/22）, respectively, and the positive likelihood ratio was 8.62, negative likelihood ratio was 0.16. Conclusion Using 3D HyCoSy on vaginal examination, the patency of fallopian tube can be directly and precisely evaluated. This procedure is simple, safe and reliable, having certain therapeutic effect of incomplete obstruction, therefore worthy for clinical application.
出处
《中国医学影像技术》
CSCD
北大核心
2013年第1期97-100,共4页
Chinese Journal of Medical Imaging Technology
关键词
造影剂
超声检查
子宫输卵管造影术
输卵管
不孕症
Contrast media
Ultrasonography
Hysterosalpingography
Fallopian tube
Infertility
