ABSTRACT
Objective To evaluate the value of diagnosis in fallopian tube patency by using four dimensional transvaginal hysterosalpingo-contrast sonography (4D-HyCoSy) and two-dimensional transvaginal hysterosalpingo-contrast sonography(2D-HyCoSy) with SonoVue in infertile women.Methods First,fifty seven infertile women(113 fallopian tubes) were examined by 4D-HyCoSy,then examined by 2D-HyCoSy,and the results of examination were respectively recorded.Results By 4D-HyCoSy,54 fallopian tubes were patency,42 were unobstructed but unsmooth flow,17 were obstructed.By 2D-HyCoSy,48 of them were patency,40 of them were unobstructed but unsmooth flow,25 of them were obstructed.Three fallopian tubes were obstructed by 4D-HyCoSy,but by 2D-HyCoSy they were patency.Eleven fallopian tubes were patency by 4D-HyCoSy,but obstructed by 2D-HyCoSy.Nine fallopian tubes were patency by 4D-HyCoSy,but fimbriated extremity of these fallopian tubes were far awary from homolateral overys.They were unuseful.Eighteen patients underwent laparoscopy,30 fallopian tubes (91.4％) were concordant with laparoscopy using combination of 4D-HyCoSy and 2D-HyCoSy,the sensitivity,specificity,positive predictive value and negative predictive value were 86.7 ％,90.5 ％,86.7 ％ and 90.5 ％.The concidence rate,sensitivity,specificity,positive predictive value and negative predictive value were 85.7％,84.6％,90.5％,84.6％ and 86.4％ by 4D-HyCoSy and 71.4％,64.7％,70.0％,64.7％ and 77.8％ by 2D-HyCoSy,respectively.Accuraty of combination of 4D-HyCoSy and 2D-HyCoSy was similar with laparoscopy.Five patients appeared moderate pelvic pain,three patients appeared mild pelvic pain,two patients appeared nausea and vomiting.None need resuscitation.Conclusions Combination of 4D-HyCoSy and 2D-HyCoSy can more accurately diagnose fallopian tube patency,it can judge if fallopian tube is valuable or not and reduce misdiagnosing.It is a simple,safe,accurate,efficient method for evaluating the fallopian tube patency.
ABSTRACT
Objective To evaluate the changes in eutopic endometrial vascularity of endometriosis using three-dimensional power Doppler ultrasound.Methods Forty-four women with endometriosis and 51 normal controls were studied by three-dimensional power Doppler ultrasound.Eutopic endometrial volume,vascularization index (VI),flow index (FI) and vascularization flow index (VFI) were calculated using VOCAL software.Results In proliferative phase,the mean VI was (5.499 ± 5.153)％ in patients with endometriosis and ( 1.135 ± 1.333) ％ in normal controls ( P ＜0.001 ),the mean FI was (28.832 ± 4.279)dB in patients with endometriosis and (25.544 ± 3.465)dB in normal controls ( P =0.006),the VFI was (1.769 ± 1.981 )dB in patients with endometriosis and (0.321 ± 0.397)dB in normal controls( P =0.002).In secretory phase,the mean VI was (8.693 ± 5.940) ％ in patients with endometriosis and ( 1.014±0.968)％ in normal controls ( P ＜0.001); the mean FI was (30.689 ± 3.632)dB in patients with endometriosis and (24.748 ± 3.811 )dB in normal controls( P ＜0.001 ),the VFI was (2.753 ± 2.044)dB in patients with endometriosis and (0.27 ± 0.293)dB in normal controls( P =0.001 ).Both in proliferative and secretory phase,no significant difference in endometrial volume between the two groups was observed ( P =0.108 and 0.068,respectively).Conclusions Three-dimensional power ultrasound provides a useful tool to investigate eutopic endometrial vascularization of endimetriosis.