实时三维宫腔输卵管超声造影结合宫腔压力监测评价输卵管通畅度价值探讨  

Transvaainal real-time three-dimensional hysterosalpingo-contrast sonography combined with intrauterine pressure monitoring in assessment of fallopian tube patency

作　　者：涂美琳[1] 李敏[1] 姚洁[1] 夏文霞[1] 彭成忠[1] 薛正妹 杭月萍 

机构地区：[1]杭州市中医院超声科,310007

出　　处：《浙江医学》2015年第21期1757-1760,共4页Zhejiang Medical Journal

摘　　要：目的探讨实时三维宫腔输卵管超声造影(real-time three-dimensional hysterosalpingo-contrast sonography,RT-3D-HyCoSy)结合宫腔压力监测在评价输卵管通畅度中的诊断价值。方法对96例临床拟诊输卵管性不孕症患者经阴道恒速注射SonoVue对比剂稀释液行实时三维超声造影,动态观察宫腔输卵管显影,监测输卵管显影时宫腔压力值和宫腔最大压力值,其中33例行腹腔镜检查。结果 96例患者192条输卵管超声造影显示输卵管通畅69条,通而不畅96条,完全梗阻27条(包括8条输卵管术后),通畅输卵管全程显影时宫腔压力为(12.5±3.3)kPa,通而不畅输卵管全程显影时宫腔压力为(22.6±4.9)kPa,两组比较差异有统计学意义(P<0.05)。其中33例输卵管造影与腹腔镜通染液结果对照表明,两种检查结果显示了较高的一致性(Kappa=0 841,P=0.000。输卵管通畅度以腹腔镜诊断为标准,输卵管全程显影时压力15.5kPa作为诊断输卵管通畅和通而不畅的截断值,灵敏度为88.4%,特异度为81.2%。所有患者均无严重不良反应。结论经阴道恒速注射SonoVue对比剂行RT-3D-HyCoSy结合宫腔压力监测可以规范化操作,动态显示输卵管的形态和显影时序及管腔压力变化,可以更准确客观地评估输卵管通畅度。Objective To evaluate the application of transvaginal real-time three-dimensional hysterosalpingo-contrast sonography （RT-3D-HyCoSy） combined with intrauterine pressure monitoring in assessment of fallopian tubal patency. Methods Fallopian tubal patency was investigated by RT-3D-HyCoSy in 96 infertile patients, and the intrauterine pressure was also monitored. The laparoscopic examination was performed in 33 cases of them. Results Among 192 fallopian tubes in 96 patients, RT-3D-HyCoSy showed that 69 tubes were freely patent, 96 were partially obstructed and 27 were completely obstructed. The intrautrerine pressure was （12.5 ± 3.3）KPa when the whole length of the patent tube was visualized, while that was （22.6 ±4.9）KPa when the whole length of partly patent tube was visualized（P〈0.05）. Using laparoscopic results as gold standard and taking 15.5 KPa as cut-off value, the sensitivity and specificity of intrauterine pressure in differentiation of patent from partially patent fallopian tube were 88.4% and 81.2%, respectively. Conclusion RT-3D-HyCoSy combined intrauterine pressure monitoring is an useful method in assessment of fallopian tubal patency.

关 键 词：输卵管通畅度 三维超声造影 宫腔压力 

分 类 号：R711.6[医药卫生—妇产科学]