经阴道四维子宫输卵管超声造影检查用于不孕症诊断的准确性及评价输卵管通畅性价值研究  

Study on the Accuracy of the Diagnosis of Infertility and the Value of Fallopian Tube Patency by Transvaginal Four-dimensional Contrast-enhanced Ultrasound

作　　者：王璐[1] 姬红丽[2] 周海霞 WANG Lu;JI Hong-li;ZHOU Hai-xia(Department of Ultrasound,The First Affiliated Hospital Zhengzhou University,Zhengzhou 450000,Henan Province,China;Department of Ultrasound,Women and Infants Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学第一附属医院超声科,河南郑州450000 [2]郑州市妇幼保健院超声科,河南郑州450000

出　　处：《罕少疾病杂志》2024年第8期96-98,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨经阴道四维子宫输卵管超声造影(4D-HyCoSy)检查用于不孕症诊断的准确性及评价输卵管通畅性价值研究。方法选取2019年6月~2022年6月我院疑似输卵管不孕症患者90例为研究对象,均行经阴道4D-HyCoSy检查,行腹腔镜输卵管通液术(LC)作为金标准。分析经阴道4D-HyCoSy对输卵管不孕的诊断效能及评价输卵管通畅性的价值。结果LC结果:90例疑似输卵管不孕患者共检查180条输卵管,左侧阻塞41条,非阻塞49条(其中通畅18条,通而不畅31条);右侧阻塞42条,非阻塞48条(其中通畅19条,通而不畅29条);经阴道4D-HyCoSy诊断左侧输卵管不孕的敏感性为80.49%(33/41),特异性为85.71%(42/49),准确性为83.33%(75/90),阳性预测值为82.50%(33/40),阴性预测值为84.00%(42/50);经阴道4D-HyCoSy诊断右侧输卵管不孕的敏感性为83.33%(35/42),特异性为89.58%(43/48),准确性为86.67%(78/90),阳性预测值为87.50%(35/40),阴性预测值为86.00%(43/50);经阴道4D-HyCoSy评价左侧输卵管通畅性的符合率为94.44%,Kappa指数=0.913;经阴道4D-HyCoSy评价右侧输卵管通畅性的符合率为93.33%,Kappa指数=0.894。结论经阴道4D-HyCoSy诊断输卵管不孕与具有较高的敏感性、特异性及准确性,且与LC结果评价输卵管通畅性的一致性较好。Objective To investigate the accuracy of transvaginal four-dimensional hysterotubal contrast ultrasound(4D-HyCoSy)in the diagnosis of infertility and the value of evaluating the patency of the fallopian tube.Methods A total of 90 suspected tubal infertility patients in our hospital from June 2019 to June 2022 were selected as research objects.All patients underwent vaginal 4D-HyCoSy examination,Performing laparoscopic tubal patency(LC)as the gold standard.To analyze the diagnostic efficacy of transvaginal 4D-HyCoSy for tubal infertility and the value of evaluating tubal patency.Results LC results:180 fallopian tubes were examined in 90 suspected patients with tubal infertility,41 fallopian tubes were blocked on the left side,49 were not blocked(18 were smooth,31 were not smooth).There were 42 obstructions on the right side and 48 non-obstructions on the right side(among which 19 were unobstructed and 29 were not smooth);the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 80.49%(33/41),85.71%(42/49),83.33%(75/90),82.50%(33/40)and 84.00%(42/50)of vaginal 4D-HyCoSy diagnosis of left tubal infertility.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of vaginal 4D-HyCoSy diagnosis of right tubal infertility were 83.33%(35/42),89.58%(43/48),86.67%(78/90),87.50%(35/40)and 86.00%(43/50)respectively.The consistency rate of vaginal 4D-HyCoSy evaluation of the patency of the left fallopian tube was 94.44%,and the Kappa index was 0.913.The agreement rate of the right fallopian tube patency evaluated by vaginal 4D-HyCoSy was 93.33%,Kappa index=0.894.Conclusion The diagnosis of tubal infertility by vaginal 4D-HyCoSy has high sensitivity,specificity and accuracy,and is in good agreement with the evaluation of tubal patency by LC results.

关 键 词：四维子宫输卵管超声造影 输卵管不孕症 输卵管通畅性 

分 类 号：R271.14[医药卫生—中医妇科学]