CAJ | 학술논문

目的：探讨经阴道三维超声造影在评估输卵管通畅性中的应用价值。方法收集2011年9月~2013年3月我院就诊的不孕患者274例共539条输卵管，全部患者均选择月经干净后3~7 d、宫腔置管注入SonoVue行经阴道三维超声造影术，在造影模式下动态观察输卵管情况，并采用经阴道三维超声造影重建技术评估输卵管通畅性；67例与腹腔镜下美兰通液术或X线碘油造影结果对照。结果274例患者共539条输卵管(其中9例一侧输卵管切除术后)，输卵管通畅230条，输卵管通而不畅224条，输卵管堵塞85条，其中输卵管积水7条；274例中造影剂逆流入子宫肌层及宫旁静脉丛3例；67例与腹腔镜或X线碘油造影对比显示其敏感性86.67%，特异性100%，阳性预测值96.30%，阴性预测值98.25%。结论三维超声造影诊断输卵管通畅性简便易行，能全面、准确地显示输卵管情况且安全有效，有望成为输卵管通畅性评估的新方法。
목적：탐토경음도삼유초성조영재평고수란관통창성중적응용개치。방법수집2011년9월~2013년3월아원취진적불잉환자274례공539조수란관，전부환자균선택월경간정후3~7 d、궁강치관주입SonoVue행경음도삼유초성조영술，재조영모식하동태관찰수란관정황，병채용경음도삼유초성조영중건기술평고수란관통창성；67례여복강경하미란통액술혹X선전유조영결과대조。결과274례환자공539조수란관(기중9례일측수란관절제술후)，수란관통창230조，수란관통이불창224조，수란관도새85조，기중수란관적수7조；274례중조영제역류입자궁기층급궁방정맥총3례；67례여복강경혹X선전유조영대비현시기민감성86.67%，특이성100%，양성예측치96.30%，음성예측치98.25%。결론삼유초성조영진단수란관통창성간편역행，능전면、준학지현시수란관정황차안전유효，유망성위수란관통창성평고적신방법。
Objective To assess the clinical value of three-dimensional hysterosalpingo-contrast sonography (3D Hy-CoSy)in patients with tubal infertility. Methods A total of 274 patients with infertility(totally 539 the fallopian tubes)from September 2011 to March 2013 in our hospital,all patients were choose 3~7 days after menstruation clean,Transvaginal three-dimensional ultrasound imaging by injecting SonoVue through the uterine tube,with dynamic obser-vation of fallopian tube in imaging mode,by adopting of transvaginal three-dimensional ultrasound imaging reconstruc-tion technology evaluate tubal patency. The result of transvaginal three-dimension ultrasound imaging among 67 cases were compared with laparoscopic Meilan hydrotubation or X-ray hysterosalpingography (HSG). Results Among 539 oviducts, 230 oviducts were diagnosed patency by HyCoSy,224 oviducts were incompletehy obstructed, and 85 oviducts were completely obstructed among which 7 were hydrosalpinx; 3 out of 274 cases were contrast medium reflux into myometrium and venous plexus nearby; The sensitivity of 3D HyCoSy was 86.67%,which compared with the re-sults of HSG and laparoscopy,specificity was 100%,positive predictive value was 96.30%, negative predictive value was 98.25%. Conclusion 3D-HyCoSy in the diagnosis of fallopian tube patency is simple, safety and effective,fully and accurately displaying the shape of uterine tube . This technique is hopeful to become an effective method to diag-nose patients with tubal infertility.