RT–4D–HyCoSy 联合 3D–TVS 检查对 不孕症女性输卵管通透性的诊断价值

Diagnostic Value of RT-4D-HyCoSy Combined with 3D-TVS on Tubal Permeability in Infertile Women

摘要:

〔摘 要〕 目的：探讨经阴道实时四维输卵管超声造影（RT–4D–HyCoSy）联合经阴道三维超声（3D–TVS）检查 对不孕症女性患者输卵管通透性的诊断价值。方法：选取 2020 年 11 月至 2021 年 11 月就诊于福州伽禾伽美医院的 不孕症患者 121 例，共诊断 242 条输卵管，所有患者均进行腹腔镜下通液术、RT–4D–HyCoSy 及 3D–TVS 检查，以 腹腔镜下通液术检查结果为 “ 金标准 ”，比较 RT–4D–HyCoSy、3D–TVS 单独及联合检查对于不孕症患者输卵管阻塞 的诊断结果及诊断效能，两种方法单独及联合检查输卵管通透性检出率，并分析 RT–4D–HyCoSy 检查的不良反应。 结果：腹腔镜下通液术检查结果显示，242 条输卵管共阻塞 54 条，其中通而不畅 86 条，通畅 102 条；与 RT–4D– HyCoSy、3D–TVS 单独检查相比，RT–4D–HyCoSy 联合 3D–TVS 联合检查诊断灵敏度 90.74 %、准确率 96.69 % 较高， 漏诊率 9.26 % 较低，差异均具有统计学意义（P ＜ 0.05）；与 RT–4D–HyCoSy、3D–TVS 单独检查相比，联合检查 对于输卵管通透性检出率更高，差异具有统计学意义（P ＜ 0.05）；与经腹腔镜下通液术不良反应发生率 20.66 % （25/121）相比，RT–4D–HyCoSy 检查的不良反应发生率 8.26 %（10/121）更低，差异具有统计学意义（P ＜ 0.05）。 结论：RT–4D–HyCoSy 联合 3D–TVS 检查对不孕症女性患者输卵管通透性的诊断价值高于单独检查，其可有效提高 诊断效能及输卵管通透性检出率，能为临床早期诊断、制定治疗方案提供更可靠的依据。

Abstract:

〔Abstract〕 Objective To investigate the diagnostic value of transvaginal real-time four-dimensional fallopian tube contrast ultrasonography (RT-4D-HyCoSy) combined with transvaginal three-dimensional ultrasound (3D-TVS) in infertile female patients with tubal permeability. Methods A total of 242 fallopingtubes were diagnosed in 121 infertile patients admitted to Fuzhou Jiahe Jiamei Hospital from November 2020 to November 2021. All patients underwent laparoscopic fluidectomy, RT-4D-HyCoSy and 3D-TVS. The results of laparoscopic fluidectomy were considered as the "gold standard". The diagnostic results and diagnostic efficacy of RT-4D-HyCoSy and 3D-TVS alone and in combination for tubal obstruction in infertile patients were compared. The detection rate of tubal permeability was examined by the two methods alone and in combination, and the adverse reactions of RT- 4D-HyCoSy were analyzed. Results The results of laparoscopy showed that 54 of 242 fallopian tubes were obstructed, of which 86 were obstructed and 102 were unobstructed. Compared with RT-4D-HyCoSy and 3D-TVS alone, RT-4D-HyCoSy combined with 3D-TVS had higher diagnostic sensitivity of 90.74%, higher accuracy of 96.69%, and lower missed diagnosis rate of 9.26%, with statistically significant differences (P < 0.05). Compared with RT-4D-HyCoSy and 3D-TVS alone, the detection rate of tubal permeability was higher by combined examination, and the difference was statistically significant (P < 0.05). The incidence of adverse reactions in RT-4D-HyCoSy was 8.26% (10/121) lower than 20.66% (25/121) of the laparoscopy, and the difference was statistically significant (P < 0.05). Conclusion The diagnostic value of RT-4D-HyCoSy combined with 3D-TVS examination is significantly higher than that of single examination, which can effectively improve the diagnostic efficiency and detection rate of tubal permeability, and has important significance for early clinical diagnosis and treatment planning.