ABSTRACT
Objective: To explore the application value of four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) with transvaginal ultrasound in evaluation of fallopian tube patency in infertile patients. Methods Clinical data of 112 infertile patients who underwent 4D-HyCoSy and laparoscopic chromopertubation using methylene blue (LC) were retrospectively analyzed. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and AUC of 4D-HyCoSy in diagnosis of tubal obstruction were calculated. Then the consistency between 4D-HyCoSy and LC in diagnosis of fallopian tube patency was evaluated. Results: A total of 218 fallopian tubes were examined in 112 infertile patients. Taken LC results as gold standards, the coincidence rates of 4D-HyCoSy in diagnosis of tubal patency, partially obstructed and completely obstructed were 88.64% (39/44), 72.09% (62/86) and 89.77% (79/88), respectively, and the overall coincidence rate was 82.57% (180/218). The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of 4D-HyCoSy in diagnosis of tubal obstruction were 80.61% (79/98), 92.50% (111/120), 89.77% (79/88), 85.38% (111/130), 10.75 and 0.19, respectively, AUC was 0.87 (P<0.01). 4D-HyCoSy had higher consistency with LC in diagnosis of tubal patency (Kappa=0.74). Conclusion: 4D-HyCoSy is consistent with LC in diagnosis of fallopian tube patency, which has high specificity in diagnosing tubal obstruction.