经阴道子宫输卵管动态三维超声造影评价输卵管通畅性及其相关因素探讨  

Evaluation of Fallopian Tube Patency and Its Relevant Factors By Transvaginal Dynamic Three-dimensional Hysterosalpingography

作　　者：裴华洁[1] 王小燕[1] 贺琰[1] 胡巧[1] 郑红雨[1] Pei Huajie;Wang Xiaoyan;He Yan;Hu Qiao;Zheng Hongyu(Department of Ultrasound,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi 530021,China)

机构地区：[1]广西壮族自治区人民医院超声科,南宁市530021

出　　处：《中国超声医学杂志》2020年第7期639-642,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广西医药卫生自筹经费科研课题(No.Z20190652)。

摘　　要：目的探讨经阴道子宫输卵管动态三维超声造影与腹腔镜通染液术评价输卵管通畅性及其相关因素。方法对88例不孕患者共176条输卵管,行动态三维超声造影,结果与腹腔镜通染液术进行对照。探讨影响输卵管通畅性相关因素。结果176条输卵管,超声造影结果显示输卵管通畅66条,通而不畅50条,阻塞60条。腹腔镜通染液术显示输卵管通畅64条,通而不畅54条,阻塞58条。动态三维超声造影诊断输卵管通畅、通而不畅、阻塞符合率为90.9%、92%、87.7%,采用Kappa检验,P>0.05,两种检查方式高度一致。动态三维超声造影诊断输卵管通畅性灵敏度为91.1%、特异度93.7%、阳性似然比8.19、阴性似然比0.12。经Logistic回归分析推注造影剂剂量、推注造影剂压力、推注造影剂反流量与通畅性有密切相关性P<0.05。结论动态三维超声造影评价输卵管通畅性与腹腔镜通染液术具有高度一致性和诊断价值;对通畅性相关因素研究,大大提高了诊断准确率。Objective Evaluation of fallopian tube patency and its relevant factors by transvaginal dynamic three-dimensional hysterosalpingography.Methods A total of 176 fallopian tubes from 88 infertile patients were subjected to dynamic three-dimensional contrast-enhanced ultrasound,and the results were compared with those of laparoscopy.Explore the related factors that affect tubal patency.Results 176 fallopian tubes.Contrast-enhanced ultrasound showed that 66 fallopian tubes were unobstructed,50 were unobstructed,and 60 were blocked.Laparoscopic drainage showed 64 tubal patency,54 unobstructed tubing,and 58 occlusions.Dynamic three-dimensional contrast-enhanced ultrasonography was used to diagnose tubal patency,obstruction,and obstruction compliance rates of 90.9%,92%,and 87.7%.Kappa test was used for P>0.05.The sensitivity of dynamic three-dimensional contrast-enhanced ultrasound in the diagnosis of tubal patency was 91.1%,specificity was 93.7%,positive likelihood ratio was 8.19,and negative likelihood ratio was 0.12.Logistic regression analysis showed that bolus contrast agent dose,bolus contrast agent pressure,and bolus contrast agent backflow were closely related to patency P<0.05.Conclusions Dynamic three-dimensional contrast-enhanced ultrasound to evaluate fallopian tube patency and laparoscopic fluid exchange have high consistency and diagnostic value.The study of patency-related factors has greatly improved the diagnostic accuracy.

关 键 词：子宫输卵管造影术 腹腔镜 超声检查 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]