三维超声造影与子宫输卵管造影诊断输卵管性不孕的临床价值比较

摘要

目的:比较经阴道子宫输卵管三维超声造影(3D-HyCoSy)和X线下子宫输卵管造影(HSG)检查在输卵管性不孕诊断中的临床价值.方法:选择2015年2月至2016年7月陕西省西安市第四医院收治的70例疑似输卵管性不孕患者作为研究对象,所有患者均行3D-HyCoSy和X线下HSG,以宫腔镜联合检查+输卵管美蓝通液术作为金标准,探讨两种检查方法在诊断输卵管性不孕的临床价值.结果:经宫腔镜联合检查+输卵管美蓝通液术证实,7例输卵管通畅,25例通而不畅,38例梗阻.3DHyCoSy和HSG诊断输卵管性不孕的曲线下面积分别为0.931和0.932,两种检查方法特异度、灵敏度及准确度比较,差异无统计学意义(P＞0.05).经Kappa一致性检验,3D-HyCoSy与HSG和宫腔镜联合检查+输卵管美蓝通液术结果高度一致(Kappa=0.849、0.949,均P＜0.001).3D-HyCoSy不良反应严重程度显著低于HSG检查(P＜0.05).结论:3D-HyCoSy用于诊断输卵管性不孕准确性高,不良反应轻,具有较高的临床应用价值.%Objective:To compare the clinical value of three-dimensional hysterosalpingo-contrast sonogra phy (3D-HyCoSy) and hystero-salpingography (HSG) in the diagnosis of tubal infertility.Methods:70 patients suspected with tubal infertility in our hospital from February 2015 to July 2016 were selected.All patients received 3D-HyCoSy and HSG examinations.The results were compared with hysteroscopy + hydrotubation with methylene blue.Results:Hysteroscopy+ hydrotubation with methylene blue tests showed that 7 cases were fallopian tube patency,25 cases were partial patency,38 cases were obstructed.The area under the ROC curve of 3D-HyCoSy and HSG for diagnosing tubal infertility were 0.931 and 0.932,respectively.There was no significant difference in specificity,sensitivity and accuracy between 3D-HyCoSy and HSG (P＞0.05).The Kappa consistency test showed that 3D-HyCoSy and HSG were highly consistent with hysteroscopy+hydrotubation with methylene blue (Kappa=0.849,Kappa=0.949;both P＜0.001).However,the severity of adverse reactions of 3D-HyCoSy was significantly lower than that of HSG (P＜0.05).Conclusion:The accuracy of 3D-HyCoSy for the diagnosis of tubal infertility was high and adverse reactions was less.It was of great value in clinical application.