四维超声子宫输卵管造影在输卵管性不孕症诊断中的应用价值  

Application value of four dimensional hysterosalpingocontrast sonography in diagnosis of tubal infertility

作　　者：马亚楠 MA Yanan(Department of Ultrasound,People’s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Uygur Autonomous Region,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院超声科,新疆乌鲁木齐830000

出　　处：《妇儿健康导刊》2025年第5期116-119,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：新疆维吾尔自治区人民医院院内项目(20200129)。

摘　　要：目的 探讨四维超声子宫输卵管造影(4D-HyCoSy)在输卵管性不孕症诊断中的应用价值。方法选取2022年1月至2024年1月于新疆维吾尔自治区人民医院就诊的76例疑似输卵管性不孕症患者(其中13例因输卵管积水、输卵管脓肿及囊肿、慢性输卵管炎症等原因,已切除一侧的输卵管,最终有139条输卵管纳入研究),均进行腹腔镜下输卵管通液术及4D-HyCoSy检查,以临床综合诊断为金标准,评估二者的诊断效能。结果 经临床综合诊断,阳性91条,阴性48条,输卵管通液术的Kappa值为0.577,表明与临床综合诊断结果有较低的一致性;4D-HyCoSy的Kappa值为0.842,表明与临床综合诊断结果有较高的一致性。4D-HyCoSy的准确度为80.58%(112/139),灵敏度为83.52%(76/91),特异度为75.00%(36/48),阳性预测值为86.36%(76/88),阴性预测值为70.59%(36/51),均高于输卵管通液术的80.58%(112/139)、83.52%(76/91)、75.00%(36/48)、86.36%(76/88)、70.59%(36/51)(P<0.05)。结论 4D-HyCoSy在输卵管性不孕症的诊断中具有较高的准确性,能够精确地评估输卵管的阻塞程度,为临床医师提供可靠的诊断依据。Objective To explore the application value of four dimensional hysterosalpingocontrast sonography(4D-HyCoSy)in diagnosis of tubal infertilit.Methods Seventy-six patients with suspected tubal infertility in Peopl e’s Hospital of Xinjiang Uygur Autonomous Region from January 2022 to January 2024 were selected(Among them,13 cases had one side of the fallopian tube removed due to hydrosalpinx,tubal abscess and cyst,chronic salpingitis and other reasons,and 139 fallopian tubes were finally included in the study),and all of them underwent laparoscopic tubal fluxing and 4D-HyCoSy,in which the diagnostic efficacy of both was evaluated with the clinical comprehensive diagnosis as the gold standard.Results After clinical comprehensive diagnosis,91 were positive and 48 were negative.The Kappa value of laparoscopic tubal fluxing was 0.577,indicating a low consistency with the results of comprehensive clinical diagnosis.The Kappa value of 4D-HyCoSy was 0.842,indicating a high consistency with the results of comprehensive clinical diagnosis.The accuracy of 4D-HyCoSy was 80.58%(112/139),the sensitivity was 83.52%(76/91),the specificity was 75.00%(36/48),the positive predictive value was 86.36%(76/88),and the negative predictive value was 70.59%(36/51),which were higher than those of laparoscopic tubal fluxing 80.58%(112/139),83.52%(76/91),75.00%(36/48),86.36%(76/88),70.59%(36/51)(P<0.05).Conclusion 4D-HyCoSy has a high accuracy in the diagnosis of tubal infertility,and can accurately evaluate the degree of tubal obstruction,providing a reliable diagnostic basis for clinicians.

关 键 词：四维超声子宫输卵管造影 输卵管性不孕症 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]