四维子宫输卵管超声造影对输卵管性不孕的诊断价值及误诊原因分析  

Analysis of diagnostic value of four-dimensional hysterotubal contrast-enhanced ultrasound in tubal infertility and causes of misdiagnosis

作　　者：阮飞娜[1] 林雁[1] RUAN Fei-na;LIN Yan(Department of Ultrasound,Zhengzhou Maternal and Child Health Care Hospital,Zhengzhou 450012,China)

机构地区：[1]郑州市妇幼保健院超声科,郑州450012

出　　处：《医药论坛杂志》2023年第20期109-112,F0003,共5页Journal of Medical Forum

摘　　要：目的 研究四维子宫输卵管超声造影在输卵管性不孕中的诊断价值,浅探误诊原因。方法 回顾性分析2019年1月至2022年5月郑州市妇幼保健院收治的102例不孕症女性患者的临床资料。全部患者进行四维超声造影,后进行腹腔镜亚甲蓝通液技术(LC)检测。以LC检测作为金标准,将患者分为双侧阻塞、一侧阻塞一侧通而不畅、一侧阻塞一侧通畅、双侧不完全通畅、一侧通而不畅一侧通畅、双侧通畅六种诊断结果,分析四维超声造影对输卵管性不孕的诊断效能,观察四维子宫输卵管超声造影过程中患者的不良反应。结合LC结果对误诊病例的图像信息进行回顾,分析误诊原因。结果 102例患者共204条输卵管,其中53条阻塞,77条通而不畅,74条通畅,四维超声造影检测结果的符合率为87.75%,与腹腔镜通液术检测结果的一致性Kappa检验值为0.8135。以LC诊断结果为金标准,102例患者诊断结果分为双侧阻塞9例、一侧阻塞一侧通而不畅17例、一侧阻塞一侧通畅18例、双侧不完全通畅22例、一侧通而不畅一侧通畅16例、双侧通畅20例;四维超声造影诊断结果的符合率为83.33%,与腹腔镜通液术诊断结果的一致性Kappa检验值为0.7976。结论 四维超声造影对输卵管性不孕具有较高的诊断效能,具有良好的推广价值;操作者经验、造影时机的选择及输卵管痉挛是误诊的主要原因。Objective To evaluate the diagnostic value of four-dimensional hysterotubal contrast-enhanced ultrasound in tubal infertility,to analyze the causes of misdiagnosis.Methods The clinical data of 102 female infertility patients admitted to our hospital from January 2019 to May 2022 were retrospectively analyzed,all patients underwent four-di⁃mensional contrastation-enhanced ultrasound,and underwent laparoscopic methylene blue solution(LC)detection.With LC test as the gold standard,patients were divided into six diagnostic results:bilateral obstruction,unilateral ob⁃struction with another incomplete patency,unilateral obstruction with another patency,bilateral incomplete patency,uni⁃lateral incomplete patency with another patency and bilateral patency,analyzed the diagnostic efficacy of four-dimen⁃sional contrast ultrasound in tubal infertility,adverse reactions were observed.Combined with the results of LC,the ima⁃ges of misdiagnosed cases were analyzed.Results Totally 102 patients had a total of 204 fallopian tubes,of which 53 were blocked,77 were not smooth,and 74 were patency.The coincidence rate of four-dimensional contrast ultrasound was 87.75%,the Kappa test value was 0.8135.Using LC as the gold standard,the diagnostic results were divided into 9 cases of bilateral obstruction,17 cases of unilateral obstruction with another incomplete patency,18 cases of unilateral ob⁃struction with another patency,22 cases of bilateral incomplete patency,16 cases of unilateral incomplete patency with another patency and 20 cases of bilateral patency.The coincidence rate of four-dimensional contrast-enhanced ultra⁃sound was 83.33%,the Kappa test value was 0.7976.Conclusion Four-dimensional contrastation-enhanced ultra⁃sound has a high diagnostic efficacy for tubal infertility,and has a good value for promotion.Experience of operator,tim⁃ing of contrast and tubal spasm are the main causes of misdiagnosis.

关 键 词：四维超声造影 输卵管 不孕 诊断效能 不良反应 误诊 

分 类 号：R445.1[医药卫生—影像医学与核医学]