输卵管声诺维三维超声造影的临床综合评价  

Clinical general evaluation of three-dimensional hysterosalpingo-contrast sonography with SonoVue in the assessment of tubal patency of infertility in 1043 cases

作　　者：蔡冬梅 陈晓丽[2] 周力学[2] 张莘[2] 周楠[2] 周守兰 王良岸[2] 

机构地区：[1]四会同济专科门诊部,肇庆526200 [2]中山大学孙逸仙纪念医院妇产超声专科,广州510120

出　　处：《新医学》2013年第12期824-827,共4页Journal of New Medicine

基　　金：广东省科技计划项目(2011B031800144)

摘　　要：目的探讨经阴道子宫输卵管声诺维三维超声造影(3D-HyCoSy)诊断输卵管性不孕症的诊断效能及优势。方法收集1 043例行输卵管3D-HyCoSy检查不孕症患者的造影资料,分析3D-HyCoSy的影像分级、其诊断输卵管通畅的三维特征以及不良反应。总结95例随后行腹腔镜下通液检查不孕症患者的输卵管3D-HyCoSy及腹腔镜下通液检查结果,以腹腔镜下通液检查为金标准,分析3D-HyCoSy对输卵管阻塞的诊断效能。结果 1 043例患者的3D-HyCoSy检查结果中,易读图像为853例,占81.8%。在通畅的输卵管中,鸟尾状或树枝状伞端溢出的出现率为93.9%。检查过程中仅8例有明显痛感。以腹腔镜下输卵管通液为金标准,3D-HyCoSy检查诊断95例患者输卵管阻塞的敏感度为93%、特异度为88%、总符合率为90%、阳性预测值为86%,阴性预测值为94%。3DHyCoSy和腹腔镜下输卵管通液检查的一致性检测的Kappa值为0.8550(P<0.01),超过0.75,有良好的一致性。结论子宫输卵管3D-HyCoSy检查具有其独特的三维影像学特征,用于评估不孕症患者输卵管通畅性安全、有效,可作为目前无创性判断输卵管通畅性的首选方法之一。Objective To investigated the feasibility and efficacy of transvaginal three-dimensional hysterosalpingo-contrast sonography using SonoVue （3D-HyCoSy）in the assessment of tubal patency. Methods One thousand and forty-three infertility patients were recruited to have 3D-HyCoSy. The image classification, feature of three-dimensional features of tubal patency and adverse reactions were analyzed. Ninety-five infertility patients were undertook laparoscopy sunsequently and the data of laparoscopy and 3D-HyCoSy were summized.With gold standard defined as pass fluid examination during laparoscopic,the diagnositic effect of 3D-HyCoSy for tubal occlusion was analyzed. Results In 1 043 patients with 3D-HyCoSy inspection results,there were 853 （81.8%）cases with readable images. In the patency of the fallopian tubes,the occurrence rate of bird-like caudate or dendritic fimbria overflow was 93.9%. Only 8 cases of the inspection process had obvious pain.In light of gold standard,the sensitivity of 3D-HyCoSy diagnosed tubal obstruction in 95 patient was 93%,spe-cificity was 88%,positive predictive value was 86%,and negative predictive value was 94%. The total com-pliance rate of two diagnosed method was 90%,Kappa value was 0.8550 （P〈0.01 ）in 3D-HyCoSy and lapa-roscopic tubal checked for consistency detection,（P〉0.75 ）suggestive of good consistency. Conclusion This study confirmed the clinical utility of 3D-SonoVue-HyCoSy as an initial investigatory tool for tubal patency.3D-SonoVue-HyCoSy could be considered as a useful,non-invasive method for evaluating tubal patency.

关 键 词：三维超声成像 声诺维 输卵管通畅性 腹腔镜 易读图像 

分 类 号：R711.76[医药卫生—妇产科学]