子宫腔碘水加压法输卵管再通术的临床研究

目的寻求一种简便快速、安全有效、经济实用,将造影诊断与输卵管再通治疗结合起来的新方法。方法应用双腔球囊胶管插入子宫腔,充盈球囊堵塞子宫颈内口,用助推器注入碘海醇充盈子宫腔及输卵管,电视动态观察实时点片,完成造影诊断。当发现输卵管阻塞时,用手助推加压,逐渐增高宫腔内压力,使阻塞输卵管被造影剂压力钝性开通。结果本组2698例,插管成功2685例。其中,原发不孕806例,继发不孕1868例,其他24例,输卵管阻塞3082支(右1561支、左1521支),占实有输卵管的59%,加压开通率为77.8%(2397/3082);通而不畅343支(右175支、左168支),加压开通率:93.9%(322/343),出现静脉逆流27例。除局部疼痛及少量阴道流血外,无严重并发症病及病死率。结论该法简便快速,安全有效,经济实用,将造影诊断与输卵管再通相结合,深受患者欢迎,值得推广应用。     

不孕症子宫输卵管碘油造影38例分析

目的:通过子宫颈管向子宫腔内注入由高原子序数构成的高比重物质碘剂,在X线摄片下与周期组织形成明显的人工对比,使管腔显影,从而了解子宫及输 卵管腔道内情况.输卵管造影不但能提示输卵管是否通畅,阻塞的部位,还能观察子宫腔形态.方法:经宫颈管插入通水管到宫腔,注入10 mL碘化油后立即摄骨盆片一张 ,24 h后再摄片一张.结果:双侧阻塞者6例,双侧通而不畅者16例,一侧不通者8例,一侧阻塞另 一侧通而不畅者4例.结论:输卵管阻塞或通而不畅是女性不孕症最常见的原因,而慢性输卵管炎 是造成输卵管阻塞的主要原因.碘油造影不孕症是妇产科疑难病症,在育龄妇女中发生率较 高.输卵管碘油造影时注入的造影剂有机械性的冲洗输卵管作用,造影时对子宫颈的牵拉作 用,可能将输卵管周围某些轻度粘连离断,碘油粘稠且易于乳化,能均匀地涂布在输卵管黏膜表面,可充分发挥碘的局部杀菌作用.     

隔室推药子宫输卵管造影的临床应用

目的探讨隔室手推造影剂子宫输卵管造影的应用价值。方法将12F硅胶球囊导管插入子宫腔，注入2-3mL生理盐水充盈球囊，使球囊堵塞子宫颈内口。延长管与球囊导管和注射器相接，用适当的压力推注造影剂，在电视监视下，确定导管位置良好且嵌塞后，逐渐加压，在子宫腔输卵管逐步充盈时，实时摄片。遇输卵管阻塞时，加压推注，能使轻度粘连阻塞的输卵管再通，发现逆流立即停止推药。结果本组检查2300例，一次造影成功2116例（92％）；二次造影成功115例（5％）；改用子宫颈塞法手推造影69例（3％）。造影示子宫输卵管正常483例（2l％），子宫病变207例（9％），输卵管病变1610例（70％），其中，463例（28．7％）阻塞的输卵管再通。患者无须在放射科插管，医师、患者受照辐射量少，推注压力能灵活调节，未出现严重的并发症。结论该法简便、经济实用、安全、推注压力可调节，图像清晰、隔室推药，辐射剂量小，对轻度粘连阻塞的输卵管有再通作用，值得推广应用。     

四维超声造影评价输卵管通畅性的方法差异性研究

目的 观察不同温度（常温、40℃稍高温）0.9%氯化钠注射推注的四维超声造影在评价输卵管通畅性中的差异,分析其临床价值。方法 以2019年1～10月期间因不孕而于本院行输卵管通畅性检查的638例育龄妇女为研究对象,所有不孕育龄妇女均先行二维超声、四维超声输卵管检查及X线碘油输卵管造影,其中2019年1～5月期间以常温0.9%氯化钠注射注入的超声检查,2019年6～10月期间以40℃的稍高温0.9%氯化钠注射注入的超声检查。以X线碘油输卵管造影检查为金标准,分析常温、40℃稍高温0.9%氯化钠注射推注的四维超声造影的输卵管通畅性检出结果,并采用SPSS软件绘制常温、40℃稍高温0.9%氯化钠注射推注的四维超声造影ROC曲线图。结果 与常温0.9%氯化钠注射推注四维超声造影比较,稍高温（40℃）0.9%氯化钠注射推注四维超声造影的输卵管远端情况显示更清晰,对输卵管“串珠状”阻塞现象亦能清晰显示。常温0.9%氯化钠注射推注四维超声造影检查出157条输卵管阻塞,与X线碘油输卵管造影检查相比,诊断符合率为85.3%(157/184)。稍高温（40℃）0.9%氯化钠注射推注四维超声造影检查出189...     

磁共振子宫输卵管成像在不孕症诊断中的应用

目的：探讨磁共振子宫输卵管造影（MR-HSG）在不孕症诊断中的应用价值。方法：对24例女性不孕患者进行盆腔磁共振扫描和MR-HSG。常规MR扫描包括横轴位T1WI,横轴面和冠状面脂肪抑制T2WI;MR-HSG应用磁共振水成像技术（MRH）,在MR磁体内通过导管向宫腔内注射0.9%生理盐水后,利用单次激发厚层投射（SS-FSE）技术进行子宫输卵管造影。结果：所有患者均能顺利进行MR-HSG检查,常规MRI可以很好地显示盆腔结构、子宫腔、黏膜、肌层及卵巢结构;MR-HSG表现为双侧输卵管阻塞者6例,输卵管单侧阻塞者9例,输卵管正常9例。结论：MR-HSG图像结合常规MRI能很好地显示输卵管、子宫、卵巢与盆腔结构,在不孕症的诊断中具有较高的临床应用价值。     

子宫输卵管造影对不孕症的应用

不孕症如何进行检查，寻找病因，对临床治疗提供比较准确依据，是医患双方共同期盼的，随着现代医疗技术不断发展，检查手段也越来越多，但是子宫输卵管造影在不孕症的诊断及指导治疗方案上仍发挥着重要的作用。子宫输卵管碘油造影(hysterosalpiongraphy，HSG)：是医院放射科的传统检查项目，通过子宫颈管向子宫腔内注入碘剂，与周围组织形成明显的人工对比，使管腔显影，从而了解子宫及输卵管腔内情况。其方法简单，副作用小，准确性高，造影不但能提示输卵管是否通畅，阻塞的部位，还能观察子宫腔形态，并了解其邻近组织器官的情况，特别是对输卵管梗阻的判断。指导治疗方案的选择以及了解子宫输卵管畸形方面具有肯定意义。而且图像清晰并可永久保存，便于治疗前后对照。     

微创治疗输卵管阻塞36例分析

1996 0 8～ 2 0 0 2 0 5 ,在我院门诊经输卵管碘油造影确诊为输卵管阻塞 3 6例 ,应用自制微导管介入再通治疗 ,取得良好效果。1　材料和方法1.1　一般资料　经输卵管碘油造影确诊为输卵管阻塞的不孕患者 3 6例 ,年龄 2 5～ 3 3岁 ,平均 2 7.6岁。农村妇女 18人 ,外地妇女 8人 ,本地居住妇女 10人。其中原发不孕 2 6例 ,继发不孕10例。 2 0例曾先后做过输卵管碘油造影 ,3 0例做过 2～ 5次输卵管通液治疗。 3 2例月经规律 ,排卵试验 ( +)。 2例月经不规律 ,2例不排卵 ,均经药物治疗后近半年月经规律 ,排卵试验( +)。所有患者男方精液检查均正…     

子宫输卵管造影对不孕症的诊断价值

目的 论证子宫输卵管造影在不孕症中的诊断价值。方法 对986例不孕症患者行子宫输卵管碘油造影，在造影时和24h后各摄盆腔正位片1张。结果 986例造影中，子宫输卵管正常98例（9.9%），输卵管炎症及积水254例（25.8%），慢性盆腔炎320例（32.5%），子宫输卵管结核160例（16.2%），子宫先天发育畸形154例（15.7%）。结论 子宫输卵管造影对女性不孕症的病因诊断有重要价值，可为临床治疗提供客观依据。     

双氧水输卵管造影B超检查不孕症15例

输卵管阻塞是女性不孕症的常见原因，通常的检查方法是用X线碘油造影。我们利用双氧水输卵管造影法，在B超显像下，观察了15例不孕症，其中有12例属输卵管阻塞，报告如下。对象和方法15例均为门诊病人，年龄27～40岁，不孕时间3～14年，平均6．7年。过去未曾作过输卵管通畅情况的检查。被检者于月经过后3～sd在膀胱中度充盈下进行检查。采用日本ALOKA，SSD－256型B型超声显像仪，探头频率3．5MNZ，图像记录用135型照相机摄影记录。患者取仰卧位，臀部稍抬高（或臀下垫一软枕），于下腹部找到子宫，纵切测量子宫大小，记录内部回声。然…     

输卵管梗阻性不孕介入治疗1726例

不孕症为妇科常见病,病因复杂多样,输卵管阻塞或通而不畅为女性不孕的重要原因,占30％-40％,近年来有上升的趋势。以往诊断这一疾病主要靠子宫输卵管通液试验和常规子宫输卵管碘油造影,但前者缺乏直观,不能准确判断输卵管阻塞的部位及程度,后者可因输卵管痉挛等因素,常出现假阳性结果,且碘油进入盆腔不易被吸收。本研究的目的在于明确输卵管阻塞的部位和程度,提供一种安全、可靠、成功率及受孕率高的治疗方法。     

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.     

球囊导管加压注射法子宫输卵管造影对不孕症的应用价值

目的探讨利用球囊导管加压注射泛影葡胺行子宫输卵管造影的应用价值。方法对219例不孕症用76%泛影葡胺采用球囊导管加压注射法作子宫输卵管造影检查,并在透视下实时点片。结果普通注射时双侧输卵管显示185例(84.47%),单侧显示24例;加压注射后203例(92.69%)双侧输卵管显示,单侧显示14例,成功率100%。子宫畸形见于9例,输卵管异常131例,造影剂弥散与吸收异常104例。结论利用球囊导管加压注射水溶性造影剂,可以明显提高子宫输卵管造影质量及输卵管再通效果,有重要的临床价值。     

MR hysterosalpingography: protocol development and refinement for simulating normal and abnormal fallopian tube patency--feasibility study with a phantom

PURPOSE: To develop and refine a pulse sequence and protocol for testing the feasibility of magnetic resonance (MR) hysterosalpingography in a phantom model. MATERIALS AND METHODS: A phantom simulating the uterus, fallopian tubes, and surrounding pelvic cavity was constructed. T2-weighted acquisition strategies-breath-hold fast spin-echo, rapid acquisition with relaxation enhancement (RARE), and haff-Fourier RARE-were refined to acquire sequential 70-mm coronal imaging volumes. Contrast agent was injected into the introducing catheter entering the os of the simulated uterus. Interacquisition interval, type of contrast agent (eg, sterile saline solution or water), and quantity of contrast agent (eg, 1-5 mL per acquisition) were varied. Digital image subtraction was used to enhance image quality. Images were qualitatively analyzed and rated good, fair, or poor for temporal resolution, spatial resolution, fallopian tube conspicuity, and free spill conspicuity. Once the technique was refine, the phantom was reconfigured to simulate unilateral and bilateral hydrosalpinx. RESULTS: The RARE sequence with an 8-second interacquisition interval and a 5-mL interacquisition of sterile water produced good images of the simulated fallopian tubes and free spill. Depiction of unilateral and bilateral hydrosalpinx was also reliably demonstrated. CONCLUSION: This study with a phantom model demonstrates the feasibility of MR hysterosalpingography to depict normal and diseased fallopian tubes.     

子宫输卵管碘油造影诊断价值分析

目的探讨子宫输卵管碘油造影的诊断价值。方法对120例资料较完整的子宫输卵管碘油造影的x线片进行分析。结果正常26例，宫腔异常5例，单侧输卵管不通39例，双侧输卵管不通27例，输卵管通而不畅23例，造影剂逆流14例。结论子宫输卵管碘滔造影是行之有效且简便实用的诊断方法。     

子宫显著屈曲患者的输卵管再通术

目的：探讨利用自制装置对子宫显著屈曲合并输卵管梗阻的不孕患者进行输卵管再通术的插管方法并分析其疗效。方法：经子宫输卵管造影证实子宫显著屈曲伴单侧或双侧输卵管阻塞患者48例,共66争输卵管阻塞,应用自制装置,配合使用各种手术器械,施行选择性输卵管造影及再通术。采用复通率及妊娠率（随访2年）评价输卵管再通术的治疗效果,并将其与子宫位置正常患者进行比较。结果：48例患者均插管成功,施行再通术后,有56条输卵管复通,复通率为84．8％,随访2年后9例妊娠,妊娠率18．8％,妊娠率低于子宫位置正常患者,而复通率与子宫位置正常患者相近。结论：使用自制装置能够较方便完成显著屈曲子宫的输卵管再通术,各种手术器械的配合使用有利于成功插管。     

Abnormalities of the uterus and cervix after diethylstilbestrol exposure: correlation of findings on MR and hysterosalpingography

We determined the value of MR for detecting abnormalities of the uterus caused by in utero exposure to diethylstilbestrol in patients in whom such abnormalities were evident on hysterosalpingography. Of 200 women with a history of diethylstilbestrol exposure in utero, 12 had undergone hysterosalpingography as part of an infertility workup. Five of these volunteered to undergo MR imaging of the pelvis. Hysterosalpingography showed abnormalities in all five patients. Abnormalities included hypoplasia of the uterine cavity (3/5), a T-shaped uterine cavity (3/5), constrictions of the uterine cavity (3/5), irregular margins of the uterine cavity (2/5), bilateral hydrosalpinges (2/5), and a diverticulum of a fallopian tube (1/5). MR images showed abnormalities in all five patients. These included hypoplasia of the uterine cavity, uterine corpus, and cervix (3/5); a T-shaped uterine cavity (3/5); constrictions of the uterine cavity (3/5); and bilateral hydrosalpinges (2/5). There was an excellent correlation between the findings on MR images and those on hysterosalpingograms. A thick junctional zone was identified on MR as the cause of constrictions of the uterine cavity seen on hysterosalpingography. MR failed to show the irregular margins of the uterine cavity in two of five cases and a diverticulum of the fallopian tube. We conclude that MR can be used to detect hypoplasia and other congenital abnormalities of the uterus in women with a history of diethylstilbestrol exposure in utero.     

A scintigraphic method of examining the patency of oviducts using 133Xe

Described below is the radioisotope method of examining the patency of oviducts using a solution of ¹³³Xe. Scintigraphic pictures of the uterine cavity and oviducts were obtained with a Jumbo Toshiba gamma-camera; they were subsequently analysed by an Informatek SIMIS-3 data processing system. A total of 30 women aged between 20 and 36 with primary or secondary infertility were examined. The patency of oviducts and the shape of the uterine cavity was assessed on the basis of: the overall picture of the activity of ¹³³Xe in the uterine cavity and oviducts, the isocontours of the overall picture, curves of increasing and decreasing activity in the fallopian tubes, and the spatial picture of activity distribution in the uterus and fallopian tubes. The results of the examinations corresponded in all cases with the diagnosis made on the basis of hysterosalpingography. An advantage of the isotope method of examining the patency of fallopian tubes and the shape of the uterine cavity is the fact that it is an examination of a dynamic nature, completely safe for the patient and exposes the patients to a considerably lower dose of irradiation than during hysterosalpingography.     

Selective transcervical fallopian tube catheterization: technique update

A technique of transcervical fallopian tube catheterization involving use of a new vacuum hysterograph and coaxial catheter set is described. In 25 women, selective catheterization of the uterine cornua was accomplished with a 94% success rate. Ostial salpingography permitted visualization of 26% of the 46 tubes found to be obstructed or poorly visualized with conventional hysterosalpingography. Recanalization was successful in 96% of 28 proximal tubal obstructions and in 33% of six midisthmic obstructions unrelated to surgery. Recanalization attempts resulted in tubal perforations without apparent clinical effects in four tubes, one with proximal and three with midisthmic postsurgical obstructions. The new hysterograph with coaxial catheter set is more suitable for recanalization of the obstructed fallopian tubes than is the previously used balloon catheter set.