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.
ABSTRACT
Objective To evaluate the feasibility of quantitative evaluation of fallopian tubes patency by the rising slope of pressure curve produced by bolus injection using a liquid diagnostic apparatus in the four-dimen-sional hysterosalpingo-contrast sonography. Methods A total of 205 patients with infertility were collected for four-dimensional hysterosalpingo-contrast sonography. In the examination,the contrast medium concentration,the liquid volume of the liquid diagnostic apparatus and the speed of the liquid were stationary calculated. The rising slope of the curve was calculated according to the real-time pressure curve produced by the contrast agent injection process. According to the hysterosalpingo-contrast sonography examination's results ,patients were divided into one side patency group,one side partial obstruction group and one side obstruction group. The correlation between the slope and the patency of the fallopian tube was analyzed by binary logistic regression. Results Binary logistic regression showed that the slope and fallopian tube patency had good correlation(all P < 0.05)between one side patency group and one side obstruction group,and also between one side partial obstruction group and one side obstruction group;but had no correlation between one side patency group and one side partial obstruction group(regression coefficient P>0.05,regression constant P=0.000). Conclusion The slope of pressure curve produced by four-dimensional hysterosalpingo-contrast sonography can be used to assess the patency of fallopian tubes quantitatively. It is a new auxiliary index for evaluating the patency of fallopian tubes.