实时灰阶超声造影对输卵管阻塞的诊断价值

摘要

Objective To investigate the application of real-time gray-scale contrast enhanced ultrasound (CEUS)imaging in the diagnosis of fallopian tube obstruction.Methods Forty-six females with infertility in the period of 3-7 days after menses were inspected by transvaginal CEUS,and the transmission of contrast agents in the fallopian tubes was observed.Then they were inspected by routine iodic X-ray salpingography.Later the value of real-time gray-scale CEUS in diagnosis of fallopian tube was evaluated.Results The sensitivity of CEUS indiagnosis of fallopian tubal unobstruction,obstruction and open without freely was 92.0%,87.1%,36.4%respectively;the specificity was 85.7%,96.7%,93.7%;the accurate was 89.1%,93.5%,84.7%;the Kappa was 0.78,0.85,0.16 with X-ray salpingography.The concordance was 83.7% between CEUS and X-ray salpingography.Conclusions There were no significant difference between CEUS and X-ray salpingography in diagnosis of fallopian tube unobstruction or obstruction,and the former method is safer and more convenient that is suitable to become an valuable method in inspecting of infertility.%目的 探讨实时灰阶超声造影对输卵管阻塞的诊断价值.方法 对临床诊断为不孕症的46例患者于月经干净后3～7 d进行经阴道实时灰阶超声输卵管造影,动态观察造影剂通过输卵管情况,同时施行常规X线输卵管碘剂造影,评价实时灰阶超声输卵管造影对诊断输卵管通畅程度的准确性.结果 实时灰阶超声造影对输卵管通畅、阻塞和通而不畅的诊断敏感性分别为92.0%、87.1%和36.4%,特异性分别为85.7%、96.7%和93.7%,准确性分别为89.1%、93.5%和84.7%;与X线输卯管碘剂造影的Kappa值分别为0.78、0.85和0.16,二者的一致率为83.7%.结论 实时灰阶超声造影与碘剂X线造影对输卵管通畅和阻塞的诊断具有高度一致性,前者安全简便,可作为女性不孕症的检查方法.