273例水溶性造影剂子宫输卵管造影的技术因素分析

目的：探讨子宫输卵管造影过程中，技术因素对造影影像质量及造影成功率的影响。方法：对273例不孕症，用76％泛影葡胺采用传统通液管法和球囊导管并加压注射法两种方式作子宫输卵管造影检查。结果：采用传统通液管法造影154．例，成功149例(96．75％)，其中125例(83．89％)双侧输卵管显示；采用球囊导管并适时加压注射法造影119例，造影成功119例(100％)，111例(93．28％)双侧输卵管显示。结论：数字点片、利用球囊导管以及加压注射，可以提高造影成功率，并明显提高输卵管的显示效率。     

DSA监视下用泛影葡胺行子宫输卵管造影

目的：评价DSA监视下应用泛影葡胺行子宫输卵管造影的效果。材料与方法：在DSA监视下361例不孕病人经导尿管注入76％泛影葡胺4-6毫升，同时采集动态图像(1帧/秒)，造影后10-15分钟内采集盆腔造影剂弥散相，选择理想图像照片。结果：361例病人子宫输卵管造影成功，图像显示清晰。，其中252例子宫及输卵管形态正常，5例子宫畸形；5例双侧输卵管未显影；39例一侧输卵管未显影；48例一侧或双侧输卵管走行扭曲、形态不规则、粗细不均；12例显示输卵管远段球形膨大扩张，远端闭塞。结论：DSA监视下用泛影葡胺行子宫输卵管造影是一种安全、方便的造影方法，值得推广使用。     

子宫输卵管造影的诊断价值与临床应用

目的：探讨子宫输卵管造影检查在不孕症中的诊断价值和临床应用。方法：采用水剂76％的泛影葡胺作造影的对比剂，利用橡胶双腔管堵塞宫颈内口适当加压注射作造影检查。结果：100例不孕患者中，子宫病变31例，输卵管病变42例，未见病变27例。结论：子宫输卵管造影简便，快捷，准确。应用76％泛影葡胺造影，影像质量达到诊断要求，且价格低廉，是检查女性不孕原因简单而必要的方法之一。     

俯卧位在子宫输卵管造影中的价值

子宫输卵管造影是女性不孕症常用的检查方法。由于造影剂经一定压力通过输卵管时,可以疏通轻度粘连或梗阻,故兼有一定的治疗作用。但有时一侧或双侧输卵管角部无任何病变或畸形而造影剂受阻,影响造影效果。1986年1～9月,我院用76％泛影葡胺或40％碘化油经Foley氏管行子宫输卵管造影150例,对12例一侧或双侧输卵管     

水溶性对比剂在不孕症子宫输卵管造影的应用价值

子宫输卵管造影(hysterosalpingography，HSG)是诊断不孕症常用的理想方法，尤其是在基层医院，利用水溶性对比剂行子宫输卵管造影的病例近年来明显增多，我们利用76％泛影葡胺行子宫输卵管造影116例。现就此法对不孕症的应用价值进行研究探讨。     

子宫输卵管碘水造影的临床应用价值

目的:探讨泛影葡胺行子宫输卵管造影的临床应用价值。材料和方法:回顾性分析193例不孕症患者行子宫输卵管碘水造影检查的术前准备、术中用药、摄片时间以及X线表现。结果:193例中,原发不孕67例,继发不孕126例造影显示正常12例;输卵管梗阻、积水121例;盆腔粘连36例;宫腔粘连11例;宫腔、盆腔粘连9例;宫颈机能不全2例;输卵管结核2例。结论:泛影葡胺应用于子宫输卵管造影,易于吸收,副反应少,影像显示清晰,检查时间短,辅助用药效果明显,值得推广应用。     

连续摄片及泛影葡胺行子宫输卵管造影

目的：探讨连续摄片及应用泛影葡胺造影利对下孕症患者行子宫输卵管造影的价值。方法：采用60％泛影茼胺510ml注入宫腔，同时连续摄片，每秒2-4帧，以子宫输卯营完全充盈满意为准。结果：60例子宫输卯管造影均显示满意，图像清晰。28例子宫输卵管通畅，19例患者一侧输卯管未显影，11例患者一侧输卵管通而不畅。2例子宫发育不良，为幼小子宫．结论：连续摄片加泛影葡胺与传统的普通摄片加碘化油相比有明显的优越性，使用更方便安全，图像是清楚。     

30％泛影葡胺用于乳腺导管造影的价值

30％泛影葡胺或复方泛影葡胺主要是用于血管造影前的碘过敏试验，因为有时用大剂量造影和不需要做过敏试验者．本院每年可剩余数10支1毫升的30％泛影葡胺。我们将其应用于乳腺导管造影，收到了良好的经济效益和技术效益。一、适应症和禁忌症非哺乳期的单侧性乳头溢液或双侧性乳     

子宫输卵管造影术对输卵管结核的诊断能力

目的评价子宫输卵管造影术对输卵管结核的诊断能力,并分析其特征性X线征象。方法84例经临床与病理组织学证实的输卵管结核患者均经子宫输卵管造影检查,该项操作是采用70%的复方泛影葡胺作为造影剂进行的。对全部患者的影像表现结合文献复习进行了回顾性分析。结果子宫输卵管造影证实,在84例输卵管结核患者中,表现为僵直型9例,壶腹部呈囊状积水型7例,锈铁丝型11例,串珠状型9例,管旁结节阴影型6例,峡部梗塞型17例,宫角阻塞变形型14例,伞端呈烟斗嘴型8例,以及输卵管阻塞合并管旁静脉返流型3例。同时,子宫腔粘连见于35例(41%),静脉及淋巴管造影剂逆流见于13例(15%)。结论子宫输卵管造影可显示输卵管结核的特征性X线征象,并能对输卵管与子宫的损伤程度做出明确诊断。     

120例子宫输卵管造影检查分析

子宫输卵管病变是不孕症患者常见的致病原因 ,子宫输卵管造影仍为临床检查不孕病患者的重要手段 ,作者将 12 0例子宫输卵管造影影像进行分析总结。1　材料与方法　　本组 12 0例病人均采用 5 0 0ｍＡＸ线摇控床监视观察 ,术前准备 ,(包括碘过敏试验 ) ,采用 6 0 %或 76 %的泛影葡胺做造影剂 ,经阴道插管 ,注药剂量为 8～ 10ｍｌ。透视下边注药边观察子宫腔及双侧输卵管的充盈过程 ,待充盈满意后用手轻揉腹部 ,进一步观察造影剂在盆腔内的弥散情况。同时在观察过程中适时摄片 ,以记录早、中、晚各期的影像特征。图 1　鞍型子宫、宫底凹陷、宫…     

Ultrasound hysterosalpingography with levovist in the diagnosis of tubaric patency]

PURPOSE. AIM: To asses the diagnostic value of hysterosalpingo-contrast sonography (HyCoSy) with Levovist(R) as alternative to conventional hysterosalpingography (HSG) in the study of infertility. MATERIAL AND METHODS: From September 1988 to March 2000 we evaluated 120 patients with a history of infertility. Thirty patients underwent both HyCoSy and HSG. HyCoSy was performed in the pre-ovulatory phase of mestrual cycle. The tecnique was the same for both examinations. After administering 15 ml contrast medium, we visualized the endometrial cavity, the flow of the contrast medium along the fallopian tubes and its passage into the peritoneum. RESULTS: In all cases Color-Power Doppler allowed visualization of the uterine cavity and of the spilling of the contrast medium into the peritoneum, yielding information on tube patency that was comparable to that obtained by conventional HSG. In 28 cases (93%) we obtained optimal visualization of the contrast medium at the level of both the endometrial cavity and the fallopian tubes. HyCoSy proved to be superior to conventional HSG in evaluating adjacent myometrial structures, adnexa and degree of follicular maturation, equal to HSG in visualizing the passage of the contrast medium into the peritoneum but inferior to HSG in imaging the fallopian tubes owing to their tortuosity. DISCUSSION AND CONCLUSIONS: The absence of ionising radiation makes HyCoSy a possible first choice examination in the evaluation of fallopian tube pathology. Conventional HSG should be kept for doubtful cases or for surgical procedures to correct mono- or bilateral obstruction.     

子宫输卵管通液测压诊疗仪的临床应用价值

目的:探讨子宫输卵管通液测压诊疗仪(简称遥控造影仪)的临床应用价值.方法:应用遥控造影仪对149例不孕症患者行子宫输卵管造影术(HSG),并观察宫腔及输卵管情况.结果:输卵管完全梗阻85条(29.5%),其中积水23条;不完全梗阻37条(12.8%),积水9条;完全通畅166条(57.7%).子宫畸形13例(8.7%);宫腔粘连16例(10.7%);子宫内膜炎31例(20.8%);子宫正常者89例(59.7%).所有病例中出现各类对比剂逆流12例(8.1%).结论:使用遥控造影仪进行子宫输卵管造影是一种安全可靠的造影方法,但子宫造影管需要进一步改进.     

Selective fallopian tube catheterisation in female infertility: clinical results and absorbed radiation dose

Clinical results of fluoroscopic fallopian tube catheterisation and absorbed radiation doses during the procedure were evaluated in 30 infertility patients with unilateral or bilateral tubal obstruction documented on hysterosalpingography. The staged technique consisted of contrast injection through an intraurine catheter with a vacuum cup device, ostial salpingography with the wedged catheter, and selective salpingography with a coaxial microcatheter. Of 45 fallopian tubes examined, 35 (78%) were demonstrated by the procedure, and at least one tube was newly demonstrated in 26 patients (87%). Six of these patients conceived spontaneously in the follow-up perod of 1–11 months. Four pregnancies were intraurine and 2 were ectopic. This technique provided accurate and detailed information in the diagnosis and treatment of tubal obstruction in infertility patients. The absorbed radiation dose to the ovary in the average standardised procedure was estimated to be 0.9 cGy. Further improvement in the X-ray equipment and technique is required to reduce the radiation dose. Correspondence to: T. Ishigaki     

99TcmO4-输卵管显像对不孕症患者腹腔镜手术的价值

目的应用99TcmO₄-输卵管显像研究不孕症患者X线子宫输卵管造影（HSG）显示机械性通畅输卵管的功能受损程度,进而研究99TcmO₄-输卵管显像对腹腔镜手术的价值。 方法对HSG显示至少一侧输卵管通畅或通而不畅的不孕症女性患者166例（通畅输卵管91条,通而不畅输卵管222条,单侧不通输卵管19条）行99TcmO₄-输卵管显像。并对HSG显示通畅的91条输卵管进行99TcmO₄-输卵管显像及腹腔镜对比分析。采用SPSS 17.0软件对HSG检查通畅输卵管99TcmO₄-显像的输卵管功能损伤程度与腹腔镜检查的输卵管通畅性进行比较并行χ2检验。 结果对HSG显示输卵管机械性通畅（包括通畅及通而不畅）的不孕症患者,99TcmO₄-输卵管显像结果显示输卵管功能受损的阳性率为78.3%。对不孕症患者HSG检查显示通畅的输卵管,行99TcmO₄-显像及腹腔镜结果比较,其差异有统计学意义（χ2=27.56,P < 0.05）。其中,若腹腔镜显示通畅,则放射性核素99TcmO₄-输卵管显像显示输卵管功能以正常及轻度受损为主;若腹腔镜显示通而不畅,则放射性核素99TcmO₄-输卵管显像显示输卵管功能以中、重度受损及无功能为主。 结论放射性核素99TcmO₄-输卵管显像对输卵管功能受损程度及通畅性的判断具有重要价值,对临床腹腔镜手术选择具有重要指导价值,尤其对HSG显示输卵管通畅的不孕症患者能否进行腹腔镜手术价值更大。     

Hysterosalpingography in the assessment of proximal tubal pathology: a review of congenital and acquired abnormalities

Tubal and peritoneal disease are the main causes of infertility. Tubal pathology can be either congenital malformation or acquired, proximal or distal, unilateral or bilateral and transient or permanent. Several imaging methods such as laparoscopy, fluoroscopy, saline infusion sonography, and hysterosalpingography (HSG) have been used in the assessment of tubal and peritoneal pathology. Although laparoscopy is the modality of choice for investigating tubal patency and pelvic structure in many infertility centers, HSG is usually the initial diagnostic method for infertility workup because of its ease of performance, accuracy, and minimal risk of complications. This method provides useful information about size, contour, and anatomy of the inner surface of the fallopian tubes and is the gold standard for evaluation of tubal lumen. Tubal and peritubal pathology show various imaging manifestations on HSG. This review illustrates the radiographic features of congenital and acquired structural abnormalities of the proximal tubal pathology and along with etiology of proximal obstruction or occlusion will be described.     

Tubal catheterization with selective salpingography in the diagnosis and therapy of fallopian tube obstruction]

Fallopian tube catheterization with selective ostial [correction of osteal] salpingography is a new technique for the diagnosis of tubal factors of infertility and also for the treatment of proximal tubal occlusion (PTO). In this study, 246 women were considered, 20-42 years old, with primary or secondary infertility, who presented a unilateral or bilateral PTO at hysterosalpingography (HSG). Catheterization and selective salpingography have been successful in 93.9% of the cases. Failures (5.6%) have been ascribed to obstructive organic diseases, where it was impossible to overcome the stenosis with the catheter or the guide-wire. Twenty-six spontaneous pregnancies were obtained (15 full-term deliveries) and 17 patients became pregnant after GIFT (13 full-term deliveries). At follow-up, after 12 months 4 of 10 patients had normal tubes, while 6 patients presented a new unilateral or bilateral PTO. No major complications occurred; nevertheless, ectopic pregnancy is a possible event, because of the mechanically re-established patency in a nonfunctioning tube.     

选择性输卵管造影与再通术对输卵管近端梗阻的疗效分析

目的 探讨选择性输卵管造影与再通术在诊治输卵管近端梗阻方面的安全性和有效性。方法 １０３例输卵管近端梗阻患者,用自制的导管施行选择性输卵管造影,若输卵管近端仍梗阻,则行输卵管再通术。结果人１３５条输卵管中有５１条仅施行选择性输卵管造影即获得再通,剩下８４条输卵管施行输卵管再通术后６４条获再通,有效率达８５．２％,随访３０例,输卵管再通术后有８例宫内妊娠和１例宫外孕,选择性输卵管造影术后有５例宫内妊     

Fallopian tubes: improved technique for catheterization

Successful fallopian tube catheterization for diagnosis or treatment of infertility combines hysterosalpingographic and angiographic techniques. An improvement in the catheterization strategy was developed so that angled, tortuous, or more distally obstructed fallopian tubes could be catheterized. In 22 patients, 38 fallopian tubes were catheterized by using this strategy. In nine tubes (24%), forceful ostial injection alone of contrast material was able to open and/or depict the fallopian tube. In 13 tubes (34%), a discrete obstruction was recanalized by using the standard fallopian tube catheterization set. In 12 tubes (32%), successful recanalization required the use of a softer, tapered guide wire and catheter. In four tubes (10%), recanalization was unsuccessful.     

Selective salpingography and tubaric catheterization in the diagnosis and treatment of fallopian tube obstruction

Fallopian tube catheterization with selective salpingography is a new technique for the diagnosis of tubal factors of sterility and also for the treatment of proximal tubal obstruction (PTO). In this study, 156 women, 20–42 years of age, with a mean duration of infertility of 5.7 years, who presented at conventional hysterosalpingography (HSG) a unilateral or bilateral PTO, were studied. Catheterization and selective salpingography was successful in 93% of the cases. Failures (6.1%) were ascribed to obliterative organic diseases, where it was impossible to overcome the stenosis with the catheter or the guidewire. Fourteen spontaneous pregnancies were obtained (7 full term deliveries, 4 miscarriages, 3 tubal pregnancies) and 11 patients became pregnant after gamete intra-fallopian transfer (GIFT). At follow-up, after 12 monts, four out of ten patients had patent tubes, while six presented a new unilateral or bilateral PTO. No major complications occurred; nevertheless, it is acknowledged that ectopic pregnancy is a possible outcome, due to the mechanical re-establishment of patency in a non-functioning tube.     

Diagnostic quality and complications of hysterosalpingography: oil- versus water-soluble contrast media--a randomized prospective study.

In a prospective randomized study of 417 patients, side effects and complications of contrast media and the diagnostic quality of images obtained after hysterosalpingography (HSG) were evaluated after use of diatrizoate meglumine (104 patients), ioxaglate (105 patients), iohexol (105 patients), or ethiodized poppy-seed oil (103 patients). The authors detected no differences among these groups in the prevalence of pain during HSG. The prevalence of lower abdominal pain and vaginal bleeding after HSG was significantly lower in the group that received ethiodized poppy-seed oil than in the three other groups. The prevalence of pelvic infection or inflammation was significantly lower with ethiodized poppy-seed oil than with water-soluble media. All contrast media provided acceptable diagnostic image quality with regard to fallopian tubes, peritoneal spill, and intraperitoneal distribution. Visualization of the uterine cavity and ampullary rugae was significantly better with water-soluble media than with ethiodized poppy-seed oil, which was associated with a high conception rate and which the authors consider preferable for HSG.