CAJ | 학술논문

目的：探讨经阴道实时三维子宫输卵管超声造影（4D-HyCoSy）在评估输卵管通.性中的应用价值。方法：对176例不孕症患者（334条输卵管）进行经阴道下4D-HyCoSy 检查，对获得图像质量进行分析，并对输卵管通.性进行评价。其中32例患者4D-HyCoSy 结果与金标准腹腔镜下通液术检查结果进行对比分析。结果：89.8%（148/176）4D-HyCoSy 图像质量优良，能有效评价输卵管的通.性。60条输卵管接受腹腔镜下通液术检查，以其结果作为对照，4D-HyCoSy 诊断输卵管通.性敏感性为95%（38/40），特异性为83.3%（15/18），阳性预测值为92.6%（38/41），阴性预测值为88.2%（15/17），准确率达91.7%（55/60）。4D-HyCoSy 诊断输卵管通.与否的准确率与腹腔镜下通液试验检查结果比较差异无统计学意义（P＝0.453）。结论：经阴道实时三维子宫输卵管超声造影技术安全、简便，可动态、立体观察输卵管的结构、走形、阻塞部位，能有效、准确地评估输卵管通.性。
목적：탐토경음도실시삼유자궁수란관초성조영（4D-HyCoSy）재평고수란관통.성중적응용개치。방법：대176례불잉증환자（334조수란관）진행경음도하4D-HyCoSy 검사，대획득도상질량진행분석，병대수란관통.성진행평개。기중32례환자4D-HyCoSy 결과여금표준복강경하통액술검사결과진행대비분석。결과：89.8%（148/176）4D-HyCoSy 도상질량우량，능유효평개수란관적통.성。60조수란관접수복강경하통액술검사，이기결과작위대조，4D-HyCoSy 진단수란관통.성민감성위95%（38/40），특이성위83.3%（15/18），양성예측치위92.6%（38/41），음성예측치위88.2%（15/17），준학솔체91.7%（55/60）。4D-HyCoSy 진단수란관통.여부적준학솔여복강경하통액시험검사결과비교차이무통계학의의（P＝0.453）。결론：경음도실시삼유자궁수란관초성조영기술안전、간편，가동태、입체관찰수란관적결구、주형、조새부위，능유효、준학지평고수란관통.성。
Objective:To investigate the application of transvaginal real-time four-dimensional hystero-salpingo-contrast-sonography(4D-HyCoSy)in the assessment of fallopian tubal patency. Methods:A total of 176 infertile patients(334 fallopian tubes)underwent transvaginal 4D-HyCoSy. Then,the image quality and tubal patency were analyzed and accessed. The 4D-HyCoSy findings of 32 patients were compared with the findings of gold-standard laparoscopic hydrotubation. Results:In 89. 8% patients( 148/ 176),the image quality of 4D-HyCoSy was good enough to assess tubal patency effectively. Compared with the control findings of 60 fallopian tubes examined by laparoscopic hydrotubation,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of tubal patency diagnosed by 4D-HyCoSy was 95%(38/ 40),83.3%(15/ 18), and of 92.6%(38/ 41),88.2%(15/ 17),and 91.7%(55/ 60),respectively. There was no statistically significant difference between the accuracy of 4D-HyCoSy diagnosing on whether the fallopian tubes were clear and the findings of laparoscopic hydrotubation(P = 0.453). Conclusion:Real-time three-dimensional hysteronsalpingo-contrast sonography Transvaginal real-time 4D-HyCoSy is safe and simple,which can observe the structure, deformation and obstruction of the fallopian tube dynamically and stereometrically,so as to assess tubal patency effectively and accurately.