四维超声子宫输卵管造影评估女性不孕症的价值  

Value of four-dimensional ultrasound hysterosalpingography in the evaluation of female infertility

作　　者：夏涛 巫敏 毛培明 杨秋实 晏如意 秦榕鲜 XIA Tao;WU Min;MAO Pei-ming;YANG Qiu-shi;YAN Ru-yi;QIN Rong-xian(Department of Ultrasound,People′s Hospital of Mingshan District,Sichuan Province,Ya′an 625100,China)

机构地区：[1]四川省雅安市名山区人民医院超声科,四川雅安625100

出　　处：《河北医科大学学报》2023年第3期334-337,共4页Journal of Hebei Medical University

基　　金：雅安市重点科技计划项目(2020yyjskf04-1)。

摘　　要：目的 研究四维超声子宫输卵管造影(four-dimensional ultrasound hysterosalpingogram, 4D-HyCoSy)评估女性不孕症的价值。方法 选取我院收治的90例疑似输卵管性不孕女性患者作为研究对象,所有患者分别接受4D-HyCoSy、子宫输卵管X线造影(hysterosalpingography, HSG)、腹腔镜检查。同时以腹腔镜检查结果为金标准,通过一致性分析明确HSG、4D-HyCoSy及两者联合诊断女性不孕症的价值。结果 不同方式检查输卵管通畅情况比较差异无统计学意义(P>0.05);经一致性分析证实,HSG评估女性不孕症的敏感度为0.680,特异度为1.000,准确率为0.822,阳性预测值为1.000,阴性预测值为0.714,Kappa=0.654;4D-HyCoSy评估女性不孕症的敏感度为0.720,特异度为1.000,准确率为0.844,阳性预测值为1.000,阴性预测值为0.741,Kappa=0.696,诊断敏感度、准确率及Kappa值均高于HSG诊断;两种检查方式联合评估女性不孕症的敏感度为0.760,特异度为1.000,准确率为0.867,阳性预测值为1.000,阴性预测值为0.769,Kappa=0.738。结论 女性输卵管性不孕行4D-HyCoSy检查诊断敏感度较高,且HSG、4D-HyCoSy联合诊断有更高价值,值得应用。Objective To investigate the value of four-dimensional ultrasound hysterosalpingogram(4D-HyCoSY) in the evaluation of female infertility.Methods A total of 90 female patients with suspected tubal infertility admitted to our hospital were selected as the research subjects.All patients underwent 4D-HyCoSY,hysterosalpingography(HSG) and laparoscopy,respectively.In the meantime,with the results of laparoscopy as the gold standard,the value of HSG,4D-HyCoSy and their combination in the diagnosis of female infertility was determined by consistency analysis.Results There was no significant difference in tubal patency between different methods(P> 0.05).The consistency analysis confirmed that the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of HSG in the evaluation of female infertility were 0.680,1.000,0.822,1.000 and 0.714,respectively(Kappa=0.654).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 4D-HyCoSy in the evaluation of female infertility were 0.720,1.000,0.844,1.000,and 0.741,respectively(Kappa=0.696),and the diagnostic sensitivity,accuracy and Kappa value of 4D-HyCosy were higher than those of HSG.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the two methods were 0.760,1.000,0.867,1.000 and 0.769,respectively(Kappa=0.738).Conclusion The diagnostic sensitivity of 4D-HyCoSy for female tubal infertility is high,and the combined diagnosis of HSG and 4D-HyCOSY has a higher value,which is worthy of application.

关 键 词：不育 女(雌)性 子宫输卵管造影术 腹腔镜检查 

分 类 号：R711.6[医药卫生—妇产科学]