实时谐波超声造影术联合经阴道四维子宫输卵管造影术在输卵管造影中的应用  

Application of Real-Time Harmonic Ultrasonography Combined with Transvaginal 4-Dimensional Hysterosalpingo-Contrast Sonography in Salpingograph

作　　者：张小田[1] 周凤英[1] ZHANG Xiaotian;ZHOU Fengying(Department of Ultrasound,Beijing Chaoyang Maternal and Child Health Care Hospital,Beijing 100021,China)

机构地区：[1]北京市朝阳区妇幼保健院超声科

出　　处：《中国医疗设备》2019年第9期85-89,共5页China Medical Devices

基　　金：2018年北京市朝阳区科委计划（CYSF1819）;中国“一站式”输卵管超声造影多中心临床研究（ChiCTR1800015519）

摘　　要：目的探讨实时谐波超声造影术联合经阴道四维子宫输卵管造影术(TVS 4D-HyCoSy)在输卵管造影中的临床应用价值。方法回顾性分析50例不育症妇女,先进行TVS 4D-HyCoSy,后进行实时谐波超声造影术。与腹腔镜下美蓝通液术作比较,对比实时谐波超声造影术联合TVS 4D-HyCoSy与TVS 4D-HyCoSy评估输卵管通畅性的价值。结果实时谐波超声造影术联合TVS 4D-HyCoSy与TVS 4D-HyCoSy评估输卵管通畅性的准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为93%、90%、93%、92%、95%和72%、64%、77%、64%、77%。一致性分析结果,TVS4D-HyCoSy与腹腔镜下美蓝通液术结果吻合度基本一致(Kappa=0.412);实时超声谐波造影术联合TVS 4D-HyCoSy与腹腔镜下美蓝通液术结果吻合度高度一致(Kappa=0.854)。实时超声谐波造影术联合TVS 4D-HyCoSy与TVS 4D-HyCoSy检查结果具有显著的统计学差异(P<0.05)。两种方法关于阻塞与否的诊断结果具有显著的统计学差异(P<0.05)。结论实时谐波超声造影术联合TVS 4D-HyCoSy能全面地掌握输卵管的走行,准确评估输卵管的通畅性,最大限度地减少误诊。Objective To explore the clinical value of real-time harmonic ultrasonography combined with transvaginal 4-dimensional hysterosalpingo-contrast sonography(TVS 4D-HyCoSy)in salpingography.Methods A total of 50 infertile women were retrospectively analyzed.TVS 4D-HyCoSy was performed first,and then real-time harmonic contrast-enhanced ultrasound was performed.The value of real-time harmonic contrast-enhanced ultrasound combined with TVS 4D-HyCoSy and TVS 4D-HyCoSy in evaluating tubal patency was compared with that of laparoscopic methylene blue hydrotubation.Results The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of real-time harmonic contrast-enhanced ultrasound combined with TVS 4D-HyCoSy and TVS 4D-HyCoSy in evaluating tubal patency were 93%,90%,93%,92%,95%and 72%,64%,77%,64%,77%,respectively.The results of consistency analysis showed that the coincidence between TVS4D-HyCoSy and laparoscopic methylene blue hydrotubation was basically the same(Kappa=0.412);the coincidence between real-time harmonic-enhanced contrast ultrasound combined with TVS 4D-HyCoSy and laparoscopic methylene blue hydrotubation was highly consistent(Kappa=0.854).The results of real-time harmonic contrast-enhanced ultrasound combined with TVS 4D-HyCoSy and TVS 4D-HyCoSy were significantly different(P<0.05).There were significant statistical differences in the diagnosis of obstruction between the two methods(P<0.05).Conclusion The real-time harmonic contrast-enhanced ultrasound combined with TVS 4D-HyCoSy can fully demonstrate the line of fallopian tubes,accurately assess the unobstructed nature of fallopian tubes and minimize misdiagnosis.

关 键 词：实时谐波超声造影 经阴道四维子宫输卵管造影术 不育 输卵管通畅性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.76[医药卫生—诊断学]