CAJ | 학술논문

目的对比X线子宫输卵管造影与99TcmO4-输卵管显像对不孕症患者输卵管病变的诊断价值.方法选择2008年1月至2009年6月间,至少一侧输卵管通畅或通而不畅的不孕症患者150例(通畅输卵管85条,通而不畅输卵管197条,单侧不通输卵管18条),分别行X线子宫输卵管造影及99TcmO4-输卵管显像.X线造影判别输卵管形态分类为正常、迂曲、僵直、扩张或积水;99TcmO4-显像诊断输卵管功能类型分别为正常、轻度、中度、重度损伤、无功能和输卵管阻塞.对检查结果进行对比分析,2种方法对输卵管异常检出率比较采用x2检验.结果共282条通畅或通而不畅输卵管.99TcmO4-显像对这些输卵管的异常检出率(81.6％,230/282)明显高于X线造影组(69.9％,197/282),x2=14.14,P＜0.05.2种方法结合,可明显提高输卵管异常检出率(89.4％,252/282).在99TcmO4-显像示功能损伤输卵管中,输卵管迂曲的发生率明显高于功能正常者(15.3％,8/52),且随功能损伤程度的加重(轻度、中度、重度、无功能)而逐渐增高(30.8％,32/104;31.4％,16/51;37.1％,13/35;42.5％,17/40);功能损伤输卵管的扩张发生率(16.3％,17/104;11.8％,6/51;17.1％,6/35;20.0％,8/40)也明显高于功能正常者(9.6％,5/52).输卵管僵直的发生率在轻、中及重度受损输卵管中分别为27.9％(29/104)、29.4％( 15/51)、28.6％( 10/35),而在输卵管无功能时则较低,为15.0％ (6/40).结论 X线子宫输卵管造影检查对输卵管形态的判断有优势,而99TcmO4-输卵管显像能较好地判断输卵管功能损伤的程度.两者结合有助于全面正确了解输卵管情况.
목적 대비X선자궁수란관조영여99TcmO4-수란관현상대불잉증환자수란관병변적진단개치.방법 선택2008년1월지2009년6월간,지소일측수란관통창혹통이불창적불잉증환자150례(통창수란관85조,통이불창수란관197조,단측불통수란관18조),분별행X선자궁수란관조영급99TcmO4-수란관현상.X선조영판별수란관형태분류위정상、우곡、강직、확장혹적수;99TcmO4-현상진단수란관공능류형분별위정상、경도、중도、중도손상、무공능화수란관조새.대검사결과진행대비분석,2충방법대수란관이상검출솔비교채용x2검험.결과 공282조통창혹통이불창수란관.99TcmO4-현상대저사수란관적이상검출솔(81.6％,230/282)명현고우X선조영조(69.9％,197/282),x2=14.14,P＜0.05.2충방법결합,가명현제고수란관이상검출솔(89.4％,252/282).재99TcmO4-현상시공능손상수란관중,수란관우곡적발생솔명현고우공능정상자(15.3％,8/52),차수공능손상정도적가중(경도、중도、중도、무공능)이축점증고(30.8％,32/104;31.4％,16/51;37.1％,13/35;42.5％,17/40);공능손상수란관적확장발생솔(16.3％,17/104;11.8％,6/51;17.1％,6/35;20.0％,8/40)야명현고우공능정상자(9.6％,5/52).수란관강직적발생솔재경、중급중도수손수란관중분별위27.9％(29/104)、29.4％( 15/51)、28.6％( 10/35),이재수란관무공능시칙교저,위15.0％ (6/40).결론 X선자궁수란관조영검사대수란관형태적판단유우세,이99TcmO4-수란관현상능교호지판단수란관공능손상적정도.량자결합유조우전면정학료해수란관정황.
Objective To compare the value of X-ray hysterosalpingography and 99Tcm pertechnetate oviduct imaging in identifying the tubal cause of infertility.Methods One hundred and fifty patients with infertility having unilateral or bilateral patent tubes were examined by both 99TcmO4- imaging and X-ray hysterosalpingography in our hospital from January 2008 to June 2009.The result of the oviduct examination by X-ray hysterosalpingography was classified as normal,tortuous,stiff,dilated or hydrops.The result by 99TcmO4- imaging was classified as having normal,mild,moderate or severe damage,nonfunctioning and tubal obstruction.The results of the two imaging modalities were compared by x2 test.Results The detection rate of tubal abnormalities by radionuclide imaging (81.6％,230/282) was higher than that by X-ray (69.9％,197/282 ; x2 =14.14,P ＜ 0.05 ) and significantly higher ( 89.4％,252/282) when combining X-ray and 99TcmO4- imaging.The incidence rate of tortuous tubes with positive 99TcmO4- imaging was significantly higher than that with normal 99TcmO4- imaging ( 15.3％,8/52).And the incidence rate increased with the severity of damage revealed by 99TcmO4- imaging (30.8％,32/104; 31.4％,16/51; 37.1％,13/35; 42.5％,17/40).The incidence rate of dilated tubes with different severity of damage revealed by 99TcmO4- imaging (16.3％,17/104; 11.8％,6/51; 17.1％,6/35; 20.0％,8/40) was significantly higher than that with normal 99TcmO4- imaging (9.6％,5/52).The incidence rates of stiff tubes in the mildly,moderately and severely damaged and nonfunctioning oviducts were 27.9％ (29/104),29.4％ ( 15/51 ),28.6％ (10/35) and 15.0％ (6/40),respectively.Conclusions Radionuclide imaging of the oviduct can determine the extent of tubal dysfunction ; while,X-ray hysterosalpingography is better for the detection of morphological abnormalities of the uterus and oviducts.Therefore,combined imaging can maximize the likelihood of identifying the tubal cause of infertility.