经阴道二维及四维子宫输卵管超声造影评价输卵管通畅性的对比研究  

Compared study of trasvaginal 2D and 4D hysterosalpingo-contrast-sonography in the assesment of tubal patency

作　　者：王锦惠[1] 门殿霞 于子芳 闫芳[1] 刘英[1] 张琼[1] 

机构地区：[1]太原市第二人民医院超声诊断科,030002 [2]山西大医院超声科

出　　处：《中国妇产科临床杂志》2015年第6期486-489,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：太原市科技局社会发展医卫专题项目(12016902)

摘　　要：目的比较经阴道二维子宫输卵管超声造影(2D-HyCoSy)和四维子宫输卵管超声造影(4DHyCoSy)评价输卵管通畅性的有效性及其临床价值。方法选择125例女性不孕症患者,采用注射用六氟化硫微泡(SonoVue)造影剂,进行2D-HyCoSy和4D-HyCoSy检查,其中35例结果与腹腔镜下通液术进行比较。对比2D-HyCoSy和4D-HyCoSy评价输卵管通畅性的价值。结果经阴道2D-HyCoSy及4D-HyCoSy评估输卵管阻塞的敏感度、特异度、阳性预测值和阴性预测值分别为84.00%、84.44%、75.00%、90.48%和92.00%、93.33%、88.46%、95.45%;准确率分别为84.28%和92.85%。两者比较,差异均有统计学意义(冇2=36.91,P<0.05)。一致性分析显示,2D-HyCoSy与腹腔镜下通液术结果吻合度基本一致,Kappa值为0.667;4D-HyCoSy与腹腔镜下通液术结果吻合度高度一致,Kappa值为0.846。结论 2D-HyCoSy和4D-HyCoSy均可准确、快速地评价输卵管通畅性。4D-HyCoSy对输卵管全程的空间走行显示更具优势,诊断更有效。Objective To demonstrate the diagnostic efficacy of transvaginal two-dimensional hysterosalpingo- contrast sonography （TVS 2D-HyCoSy） and transvaginal four-dimensional hysterosalpingo-contrast sonography （TVS 4D-HyCoSy） on evaluation patency of fallopian tubes. Methods TVS 2D and 4D-HyCoSy with SonoVue was performed in 125 infertile women. Among them, 35 patients accepted laparoscopic examination and the diagnostic performance （sensitivity, specificity, positive predictive value and negative predictive value） of TVS 2D-and 4D- HyCoSy was assessed. Results The sensitivity, specificity, positive predictive value and negative predictive value of TVS 2D-HyCoSy and TVS 4D-HyCoSy for evaluation of tubal obstruction were 84.00%, 84.44%, 75.00%, 90.48% and 88.00%, 99.48%, 97.78%, 96.95% respectively. There was significant difference （Z2 = 36.91, P 〈 0.05） compared TVS 2D-HyCoSy to TVS 4D-HyCoSy. The accordance of TVS 2D-HyCoSy and laparoscopy was good, Kappa value was 0.667 ~ The accordance of TVS 4D-HyCoSy and laparoscopy was better with Kappa value of 0.846. Conclusion Both 2D-HyCoSy and 4D-HyCoSy can diagnose tubal patency accurately and quickly, while 4D-HyCoSy has more advantages in image display and higher effectiveness.

关 键 词：超声检查 子宫输卵管超声造影 输卵管 不孕症 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.6[医药卫生—诊断学]