经阴道实时三维超声输卵管造影结合彩色多普勒血流显像检查评估不孕症患者输卵管通畅性的价值  

The value of RT⁃3D⁃HyCoSy combined with CDFI in evaluating tubal patency in infertile patients

作　　者：陈孝宪 鲁正贤 卫耀阳 Chen Xiaoxian;Lu Zhengxian;Wei Yaoyang(Department of Ultrasound,Lu’an Civily Hospital,Lu’an 237000,China)

机构地区：[1]安徽省六安世立医院超声科,安徽六安237000

出　　处：《海军医学杂志》2024年第7期745-749,共5页Journal of Navy Medicine

摘　　要：目的探讨经阴道实时三维超声输卵管造影(RT⁃3D⁃HyCoSy)结合彩色多普勒血流显像(CDFI)检查评估不孕症患者输卵管通畅性的价值。方法选取2019年1月至2023年2月在安徽省六安世立医院就诊的96例不孕症患者作为研究对象,所有研究对象均接受RT⁃3D⁃HyCoSy、CDFI等检查,以腹腔镜或X线子宫输卵管碘油造影结果为金标准,分析RT⁃3D⁃HyCoSy、CDFI判断输卵管通畅情况的价值。结果RT⁃3D⁃HyCoSy判断输卵管通畅性与输卵管碘油造影或腹腔镜手术结果具有一致性,Kappa值为0.819,P<0.05,RT⁃3D⁃HyCoSy判断输卵管通畅性准确率为88.54%。输卵管通畅患者子宫动脉收缩期峰值血流速度(PSV)为(36.76±5.52)cm/s,大于通而不畅患者[(31.18±6.02)cm/s]和阻塞患者[(27.12±5.98)cm/s],差异有统计学意义(P<0.05),而搏动指数(PI)和阻力指数(RI)分别为2.03±0.67和0.76±0.10,低于通而不畅(2.65±0.58)和0.83±0.11)阻塞患者(2.92±0.55和0.90±0.12),差异有统计学意义(P<0.05)。Logistic回归分析显示,PSV、PI和RI是输卵管通畅的影响因素(P<0.05)。PSV、PI和RI诊断输卵管通畅的ROC曲线下面积分别为0.741、0.722和0.747(P<0.05)。RT⁃3D⁃HyCoSy结合CDFI检查评估输卵管通畅的灵敏度和阴性预测值分别为97.14%和98.15%,高于RT⁃3D⁃HyCoSy(82.85%和90.63%),而特异度和阳性预测值分别为86.69%和80.95%,低于RT⁃3D⁃HyCoSy(96.08%和90.63%),但差异无统计学意义(P>0.05)。结论RT⁃3D⁃HyCoSy结合CDFI检查评估不孕症患者输卵管通畅性有较好的应用价值,值得进一步研究。Objective To explore the value of transvaginal real⁃time three⁃dimensional hysterosalpingo⁃contrast sonography(RT⁃3D⁃HyCoSy)combined with color Doppler flow imaging(CDFI)in evaluating the tubal patency in patients with infertility.Methods A total of 96 patients with infertility who were admitled to Lu’an Civily Hospital from January 2019 to February 2023 were selected as research objects.All the patients received RT⁃3D⁃HyCoSy and CDFI.The results of laparoscopy or X⁃ray hysterosalpingography were taken as the gold standard.The value of RT⁃3D⁃HyCoSy and CDFI in judging the tubal patency was analyzed.Results There was consistency between RT⁃3D⁃HyCoSy result and final diagnosis(laparoscopy or hysterosalpingography)in judging tubal patency(Kappa value was 0.819,P<0.05).The accuracy of RT⁃3D⁃HyCoSy in judging the tubal patency of was 88.54%.The peak systolic velocity(PSV)of uterine artery in patients with fallopian tube unblocked was(36.76±5.52)cm/s,which was significantly higher than that in patients with fallopian tube partial obstruction and fallopian tube obstruction([31.18±6.02]cm/s,[27.12±5.98]cm/s,both P<0.05).The pulsation index(PI)and resistance index(RI)in patients with fallopian tube unblocked were 2.03±0.67 and 0.76±0.10,respectively,which were significantly lower than those in patients with fallopian tube partial obstruction(2.65±0.58 and 0.83±0.11)and fallopian tube obstruction(2.92±0.55 and 0.90±0.12)(all P<0.05).Logistic regression analysis showed that PSV,PI,and RI were the influencing factors for tubal patency(all P<0.05).The area under the ROC curve values of PSV,PI and RI for diagnosis of tubal patency were 0.741,0.722 and 0.747,respectively(P<0.05).The sensitivity and negative predictive value of RT⁃3D⁃HyCoSy combined with CDFI in assessing tubal patency were 97.14%and 98.15%,respectively,which were higher than RT⁃3D⁃HyCoSy alone(82.85%and 90.63%)(P>0.05).The specificity and positive predictive value of RT⁃3D⁃HyCoSy combined with CDFI in assessing

关 键 词：经阴道实时三维超声输卵管造影 彩色多普勒血流显像 不孕症 输卵管通畅性 

分 类 号：R711.6[医药卫生—妇产科学]