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目的:探讨经阴道实时三维子宫输卵管超声造影(4D-Hy Co Sy)在评估输卵管通畅性中的应用价值。方法:对176例不孕症患者(334条输卵管)进行经阴道下4D-Hy Co Sy检查,对获得图像质量进行分析,并对输卵管通畅性进行评价。其中32例患者4D-Hy Co Sy结果与金标准腹腔镜下通液术检查结果进行对比分析。结果:89.8%(148/176)4D-Hy Co Sy图像质量优良,能有效评价输卵管的通畅性。60条输卵管接受腹腔镜下通液术检查,以其结果作为对照,4D-Hy Co Sy诊断输卵管通畅性敏感性为95%(38/40),特异性为83.3%(15/18),阳性预测值为92.6%(38/41),阴性预测值为88.2%(15/17),准确率达91.7%(55/60)。4D-Hy Co Sy诊断输卵管通畅与否的准确率与腹腔镜下通液试验检查结果比较差异无统计学意义(P=0.453)。结论:经阴道实时三维子宫输卵管超声造影技术安全、简便,可动态、立体观察输卵管的结构、走形、阻塞部位,能有效、准确地评估输卵管通畅性。
Objective: To investigate the value of transvaginal real-time three-dimensional ectopic contrast-enhanced ultrasound (4D-Hy Co Sy) in the evaluation of tubal patency. Methods: Transvaginal 4D-Hy Co Sy was performed on 176 infertile patients (334 tubal tubes). The image quality was analyzed and the tubal patency was evaluated. 32 cases of patients with 4D-Hy Co Sy results and gold standard laparoscopic fluid examination results were compared. Results: 89.8% (148/176) 4D-Hy Co Sy had good image quality and could effectively evaluate tubal patency. Sixty tubal tubes were examined by laparoscopic fluid-passing technique. According to the results, 4D-Hy Co Sy had a sensitivity of 95% (38/40) and a specificity of 83.3% (15/18) for the diagnosis of tubal patency. The positive rate The predictive value was 92.6% (38/41), the negative predictive value was 88.2% (15/17) and the accuracy rate was 91.7% (55/60). The accuracy of 4D-Hy Co Sy in diagnosing tubal patency was not significantly different from that of laparoscopic fluid-passing test (P = 0.453). Conclusion: Transvaginal real-time three-dimensional hysterosalpingography is a safe, simple, dynamic and stereoscopic method to observe the structure, shape and occlusion of the fallopian tube, and to evaluate tubal patency effectively and accurately.