碘油子宫输卵管造影快速诊断输卵管粘连性病变的可行性分析  

Analysis of the clinical feasibility of using lipiodol hysterosalpingography for rapid diagnosis of fallopian tubal adhesion

作　　者：鲁景元[1] 刘旸 徐文健[1] 顾建平[3] LU Jingyuan;LIU Yang;XU Wenjian;GU Jianping(Department of Interventional Radiology,Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210004,China)

机构地区：[1]南京医科大学附属妇产医院介入科,江苏南京210004 [2]南京医科大学附属妇产医院妇科,江苏南京210004 [3]南京医科大学附属南京医院介入血管科

出　　处：《介入放射学杂志》2023年第3期243-246,共4页Journal of Interventional Radiology

基　　金：江苏省妇幼保健协会项目(FYX202010)。

摘　　要：目的 了解碘油子宫输卵管造影(HSG)快速诊断输卵管粘连性病变的可行性。方法 选取2021年3月至2021年9月因不孕在南京医科大学附属妇产医院行碘油HSG的患者103例,并分别于检查后2、6和24 h拍摄延迟片。以24 h延迟片作为碘油HSG诊断输卵管粘连性病变的标准图像。分别评估2 h、6 h延迟片与标准图像的诊断一致性。运用Kappa检验分析2 h与24 h延迟片,以及6 h与24 h延迟片诊断输卵管粘连性病变的一致性。绘制2 h和6 h延迟片诊断输卵管粘连性病变的ROC曲线并计算曲线下面积Az值。结果 2 h和24 h延迟片对比,两者诊断一致性一般(Kappa值0.503,McNemar检验P<0.01),而6 h和24 h延迟片对比,两者诊断一致性较高(Kappa值0.810,McNemar检验P<0.01);以24 h延迟片作为参照,基于2 h延迟片诊断输卵管粘连性病变的诊断准确率中等(Az2h=0.879,P<0.01),而基于6 h延迟片诊断输卵管粘连性病变的诊断准确率较高(Az6h=0.965, P<0.01)。结论 缩短碘油HSG延迟片拍摄时间对输卵管粘连性病变进行快速诊断是可行的。Objective To discuss the feasibility of lipiodol hysterosalpingography(HSG)for rapid diagnosis of fallopian tubal adhesion.Methods A total of 103 female infertility patients,who were admitted to the Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University of China to receive lipiodol HSG between March 2021 and September 2021,were enrolled in this study.After HSG,2-,6-and 24-hour delayed radiograms were taken.Taking 24-hour delayed radiogram as the standard picture for diagnosing tubal adhesion lesions,the diagnostic consistency between 2-hour,6-hour delayed images and standard image was separately evaluated.Kappa test was used to assess the consistency between 2-hour and 24-hour delayed images as well as between 6-hour and 24-hour delayed images in diagnosing tubal adhesion lesions.ROC curves of 2-hour and 6-hour delayed images for diagnosing tubal adhesion lesions were drawn separately and the area under curve(Az value)was calculated.Results The consistency in diagnosing tubal adhesion between 2-hour and 24-hour delayed images was medium(Kappa value=0.503,McNemar test P=0.01),while the consistency in diagnosing tubal adhesion between 6-hour and 24-hour delayed images was high(Kappa value=0.810,McNemar test P<0.01).Taking 24-hour delayed image as the reference,the diagnostic accuracy of 2-hour delayed image for tubal adhesion was medium(Az2h=0.879,P<0.01),while the diagnostic accuracy of 6-hour delayed image for tubal adhesion was high(Az6h=0.965,P<0.01).Conclusion It is clinically feasible to shorten the shooting time of lipiodol HSG delayed radiograms for making rapid diagnosis of tubal adhesion.

关 键 词：碘油 子宫输卵管造影 输卵管粘连 可行性分析 延迟片 

分 类 号：R711.76[医药卫生—妇产科学]