超声造影对不同类型子宫发育异常及其输卵管通畅性的评估

目的探讨经阴道实时三维子宫输卵管超声造影（RT-3D-HyCoSy）评估不同类型子宫发育异常及输卵管通畅性的方法与应用价值。 方法选取2015年1月至2019年4月于四川大学华西第二医院就诊，经RT-3D-HyCoSy诊断为子宫发育异常的不孕症患者34例。应用RT-3D-HyCoSy评估子宫发育异常的不同类型及输卵管通畅性，对子宫畸形类型及无法评估输卵管通畅性的原因进行分析。 结果34例患者中，纵隔子宫13例（38.2%），单角子宫12例（35.3%），双子宫6例（17.7%），弓形子宫3例（8.8%）。34例患者中，输卵管缺如4条；输卵管通畅34条，输卵管通而不畅6条，输卵管阻塞9条；无法评估结果的输卵管15条，分别为8例单角子宫合并残角子宫、4例双子宫、3例完全纵隔子宫患者的一侧输卵管无法评估，其主要原因为宫腔置管失败。 结论对合并子宫发育异常的不孕症患者而言，RT-3D-HyCoSy既能明确子宫发育异常的类型，也能较准确地评估输卵管通畅性，不失为一种筛查不孕症原因的重要和有效方法。但仍有部分输卵管因宫腔置管失败而无法评估。

Hysterosalpingo-contrast sonography for assessment of uterine malformations and patency of fallopian tube

Objective To investigate the practical value of real-time three-dimensional hysterosalpingo-contrast sonography(RT-3D-HyCoSy)in fertile patients with uterine malformation.Methods Thirty-four patients with uterine malformations diagnosed by RT-3D-HyCoSy were selected at the West China Second University Hospital from January 2015 to April 2019.The patients were examined by RT-3D-HyCoSy to evaluate uterine malformations and the patency of fallopian tubes.The types of uterine malformations and the causes of failure to evaluate the patency of fallopian tubes were analyzed.Results A total of 34 patients were diagnosed withuterine malformations,including 13(38.2%)cases of septate uterus,12(35.3%)cases of unicornuate uterus,6(17.7%)cases of didelphus,and 3(8.8%)cases of arcuate uterus.Among the 34 cases included,there were 4 missing fallopian tubes,34 unobstructed fallopian tubes,6 partially obstructed fallopian tubes,and 9 obstructed fallopian tubes;15 fallopian tubes could not be evaluated,of which 8 were unicornuate uterus with residual horn uterus,4 were didelphus,and 3 were complete septate uterus with one fallopian unevaluable.The main reason for not being evaluable was the failure of uterine catheterization.Conclusion For infertility patients with uterine malformation,RT-3DHyCoSy can not only identify the types of uterine malformation,but also accurately assess the patency of fallopian tubes,representing an important and effective means to screen the causes of infertility.However,some fallopian tubes can not be evaluated due to the failure of uterine catheterization.