Diagnosis of fallopian tube patency by combination of four-dimensional and two-dimensional transvaginal hysterosalpingo-contrast sonography / 中华超声影像学杂志

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.