经阴道四维超声造影联合宫腔通液术评价输卵管伞端通畅性的研究  

Assessment of tubal fimbria patency by combination of transvaginal four-dimensional hysterosalpingo-contrast sonography with uterine tubal liquid poking

作　　者：王伟群[1] 周秋兰[1] 黎月薇[1] 龚亚飞[1] 陈智毅[1] 李载红[2] 

机构地区：[1]广州医科大学附属第三医院超声医学科,510150 [2]海南省人民医院超声科

出　　处：《中华超声影像学杂志》2017年第8期698-702,共5页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（81671707）;广东省自然科学基金（2016A030311054）;广州市科技计划项目（201607010201）

摘　　要：目的探讨经阴道四维子宫输卵管超声造影（transvaginal four—dimensional hysterosalpingo—contrast sonography，TVS4D-HyCoSy）联合超声引导下宫腔通液术评价输卵管伞端通畅性的临床价值。方法回顾性分析62例经TVS4D-HyCoSy提示输卵管伞端阻塞或不全阻塞并盆腔粘连，并于3个月内行腹腔镜下美蓝通染液检查的患者，观察其输卵管伞端造影剂溢出与卵巢周围包绕情况。结果与腹腔镜下美蓝通染液检查比较，TVS4D-HyCoSy联合超声引导下宫腔通液术诊断输卵管伞端阻塞的符合率为94．3％，敏感度为90．1％，特异度为94．1％。造影结果显示，输卵管伞端阻塞侧其卵巢周围，80％未显示环状造影剂强回声，输卵管伞端通畅侧其卵巢周围85．5％显示环状造影剂强回声。结论TVS4D-HyCoSy联合超声引导下宫腔通液术能实时动态显示造影剂在输卵管伞端溢出性和盆腔粘连情况，在评价输卵管伞端通畅程度和盆腔粘连方面具有很好的临床应用价值。Objective To investigate the clinical value of combination of transvaginal four- dimensional hysterosalpingo-contrast sonography（TVS 4D-HyCoSy） with uterine tubal liquid poking in assessment tubal fimbria patency. Methods Sixty-two female infertile patients with obstruction at tubal fimbria, or partial obstruction with pelvic adhesion were included. All of them were underwent 4D-HyCoSy as well as uterine tubal liquid poking, and were followed with laparoscopic chromopertubation （LPC） using Methylene blue in three months. Results Comparing with laparoscopy, the total coincidence rate of 4D- HyCoSy to assess the tubal fimbria patency was 94.3%, with the sensitivity of 90. 1% and specificity of 94.1%. Imaging results showed that the obstruction at tubal fimbria, uncircle-like wrapping contrast medium can be seen around ovary accounted for 80%. The patent fallopian tube fimbria, circle-like wrapping of contrast medium can be observed around ovary accounted for 85.5 %. Conclusions The combination of TVS 4D-HyCoSy with uterine tubal liquid poking is highly in accordance with LPC by providing real-time dynamic visualization on overflowing of contrast medium from tubal fimbria, as well as the pelvic adhesion surrounding ovaries. The 4D-HyCoSy can be the preferred method for assessment of tubal fimbria patency and pelvic adhesion surrounding ovaries with its advantages of accuracy, non-invasion and a good safety profile.

关 键 词：超声检查 三维 子宫输卵管造影术 输卵管开放试验 

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]