子宫输卵管超声造影时间-强度曲线分析在不孕女性中的应用价值

摘要

目的 评价造影剂SonoVue高压恒速注射子宫输卵管超声造影(HyCoSy)检查及时间-强度曲线在女性不孕症诊断中的应用价值.方法 对56例女性输卵管不孕患者以SonoVue为造影剂采用球囊导管加压注射法进行HyCoSy检查并利用ACQ软件进行时间-强度曲线分析.超声造影后分别取得输卵管部分通畅组和正常对照组从宫腔到输卵管伞部周边盆腔的造影剂通过时间(AT),并对两组间进行统计学分析.结果 输卵管部分通畅组的AT为(3.49±1.70)s,正常通畅组为(1.14±0.37)s,两组比较差异有统计学意义(P=0.000).经ROC曲线分析得出,以AT 1.65 s作为诊断输卵管部分通畅输的最佳工作点,灵敏性为92.6％,特异性为93.3％,阳性预测值96.2％,阴性预测值87.5％.结论 利用高压注射器进行HyCoSy有利于规范化操作,显示高质量输卵管图像.ACQ曲线分析从宫腔到输卵管伞部周边盆腔的AT是检查输卵管通畅性的有效诊断指标.%Objective To investigate the clinical value of hysterosalpingo-contrast-sonography (HyCoSy) with high-pressure syringe injection and time-intensity curve analysis in the diagnosis of women infertility due to tube obstruction.Methods Fifty-six women with infertility underwent HyCoSy with compressive injection of SonoVue with a balloon catheter and high-pressure syringe.Time-intensity curve based on Autotracking Contrast Quatification (ACQ) software was analyzed in all patients.The arrival time (AT) of microbubbles from uterine cavity to tube fimbria was analyzed between partially obstructed tube group and control group.Results The AT in the group of partially obstructed tubes was (3.49 ± 1.70) s,while the AT in the group of freely patent tubes was (1.14-± 0.37)s,there was statistical difference of AT between the group of partially obstructed tubes and the group of freely patent tubes (P =0.000).According to ROC results,the optimization point of AT was 1.65 s,the sensitivity,specificity,positive predictive value and negative predictive value were 92.6％,93.3％,96.2％ and 87.5％,respectively.Conclusions High-pressure syringe injection in HyCoSy is useful for regular administration and high image quality.The AT could be considered as the diagnostic indices in the evaluation of fallopian tube patency for infertile women.