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目的探讨子宫输卵管实时三维超声造影在不孕症临床诊治中的应用价值。方法对近4年来我院就诊的不孕症患者的诊治情况进行回顾性分析,以腹腔镜输卵管通液术(LTF)的结果为金标准,分析输卵管碘水造影(HSG)、子宫输卵管实时三维超声造影(RT 3D-HyCoSy)诊断输卵管病变的准确率,评估其临床应用价值。结果不孕症患者3 558例进行HSG,2 188例进行RT 3D-HyCoSy,其中198例进行LTF治疗。对输卵管通畅程度的评估,HSG、RT 3D-HyCoSy与LTF的总符合率分别为52.5%(Kappa=0.244)、67.9%(Kappa=0.456);对输卵管有无积水的评估,HSG、RT 3D-HyCoSy与LTF的总符合率分别为73.5%(Kappa=0.472)、85.3%(Kappa=0.648)。结论 RT 3D-HyCoSy在判断输卵管通畅程度和积水方面明显优于HSG。
Objective To investigate the value of real-time three-dimensional contrast-enhanced ultrasound in the diagnosis and treatment of infertility. Methods The diagnosis and treatment of infertility patients treated in our hospital during the past 4 years were retrospectively analyzed. The results of laparoscopic tubal fluid-entry (LTF) as the gold standard were analyzed. The results of HSG, Contrast-enhanced ultrasound (RT 3D-HyCoSy) diagnosis of tubal lesions, to assess its clinical value. Results 3 558 infertile patients underwent HSG, and 2 188 RT 3D-HyCoSy were performed, 198 of whom underwent LTF. The coincidence rates of HSG, RT 3D-HyCoSy and LTF were 52.5% (Kappa = 0.244) and 67.9% (Kappa = 0.456), respectively. The assessment of tubal water availability, HSG, RT 3D The overall coincidence rates of -HyCoSy and LTF were 73.5% (Kappa = 0.472) and 85.3% (Kappa = 0.648), respectively. Conclusion RT 3D-HyCoSy is superior to HSG in judging tubal patency and water retention.