三维超声造影在评估输卵管通畅性中的应用分析

目的：探讨经阴道三维超声造影在评估输卵管通畅性中的应用价值。方法收集2011年9月~2013年3月我院就诊的不孕患者274例共539条输卵管，全部患者均选择月经干净后3~7 d、宫腔置管注入SonoVue行经阴道三维超声造影术，在造影模式下动态观察输卵管情况，并采用经阴道三维超声造影重建技术评估输卵管通畅性；67例与腹腔镜下美兰通液术或X线碘油造影结果对照。结果274例患者共539条输卵管（其中9例一侧输卵管切除术后），输卵管通畅230条，输卵管通而不畅224条，输卵管堵塞85条，其中输卵管积水7条；274例中造影剂逆流入子宫肌层及宫旁静脉丛3例；67例与腹腔镜或X线碘油造影对比显示其敏感性86.67%，特异性100%，阳性预测值96.30%，阴性预测值98.25%。结论三维超声造影诊断输卵管通畅性简便易行，能全面、准确地显示输卵管情况且安全有效，有望成为输卵管通畅性评估的新方法。

The application value in the evaluation of the patency of the fallopian tube by three-dimensional SonoVue-hysterosalpingo-contrast sonography

Objective To assess the clinical value of three-dimensional hysterosalpingo-contrast sonography （3D Hy-CoSy）in patients with tubal infertility. Methods A total of 274 patients with infertility（totally 539 the fallopian tubes）from September 2011 to March 2013 in our hospital,all patients were choose 3~7 days after menstruation clean,Transvaginal three-dimensional ultrasound imaging by injecting SonoVue through the uterine tube,with dynamic obser-vation of fallopian tube in imaging mode,by adopting of transvaginal three-dimensional ultrasound imaging reconstruc-tion technology evaluate tubal patency. The result of transvaginal three-dimension ultrasound imaging among 67 cases were compared with laparoscopic Meilan hydrotubation or X-ray hysterosalpingography （HSG）. Results Among 539 oviducts, 230 oviducts were diagnosed patency by HyCoSy,224 oviducts were incompletehy obstructed, and 85 oviducts were completely obstructed among which 7 were hydrosalpinx; 3 out of 274 cases were contrast medium reflux into myometrium and venous plexus nearby; The sensitivity of 3D HyCoSy was 86.67%,which compared with the re-sults of HSG and laparoscopy,specificity was 100%,positive predictive value was 96.30%, negative predictive value was 98.25%. Conclusion 3D-HyCoSy in the diagnosis of fallopian tube patency is simple, safety and effective,fully and accurately displaying the shape of uterine tube . This technique is hopeful to become an effective method to diag-nose patients with tubal infertility.