Radić Vanja, Canić Tomislav, Valetić Josip, Duić Zeljko
Merkur University Hospital, Zajceva 19, 10000 Zagreb, Croatia.
Eur J Radiol. 2005 Feb;53(2):268-73. doi: 10.1016/j.ejrad.2004.02.015.
Hysterosonosalpingography as a contrast ultrasound method is safer, cheaper and easier to perform than hysterosalpingography in the assessment of the uterine cavity and fallopian tubes. Is it feasible for all patients? Which is the main problem in the evaluation of target structures by ultrasound?
In a prospective study, 68 patients in the initial stage of the infertility treatment were examined by hysterosonosalpingography using saline NaCl infundibile and Echovist as contrast media. Subsequently, further status of the tubes and uterine cavity was assessed by the "gold standards", laparoscopy and hysteroscopy.
Sensitivity and specificity of hysterosonosalpingography using NaCl infundibile for evaluation of the uterine cavity was 100 and 88.8%, respectively. Negative predictive value was 100% and positive predictive value 97%. Sensitivity and specificity of the method for the assessment of the tubal status was 100 and 66%, respectively, negative predictive value was 100% and positive predictive value was 61%. For the assessment of tubal patency using positive contrast Echovist the method has shown 100% sensibility and negative predictive value again but it reached a specificity of 77% and a positive predictive value of 70%. There were no evident complications during or after the procedure.
Hysterosonosalpingography is useful in making decisions regarding further procedures for the diagnosis and treatment of infertility. Uterine cavity evaluation using saline is the method of choice. Tubal patency can be assessed only under ideal sonographic conditions. The method is feasible for early assessment of the reproductive status of uterine cavity and fallopian tubes as a simple, safe and cheap outpatient method prior to any following invasive procedure or even histerosalpingography.
子宫输卵管超声造影作为一种超声造影方法，在评估子宫腔和输卵管方面比子宫输卵管造影更安全、更便宜且操作更简便。它对所有患者都可行吗？超声评估目标结构的主要问题是什么？
在一项前瞻性研究中，对68例不孕症治疗初期的患者进行子宫输卵管超声造影检查，使用生理盐水氯化钠注入剂和超声造影剂Echovist作为造影剂。随后，通过“金标准”腹腔镜检查和宫腔镜检查进一步评估输卵管和子宫腔的状况。
使用生理盐水氯化钠注入剂进行子宫输卵管超声造影评估子宫腔的敏感性和特异性分别为100%和88.8%。阴性预测值为100%，阳性预测值为97%。该方法评估输卵管状况的敏感性和特异性分别为100%和66%，阴性预测值为100%，阳性预测值为61%。使用阳性造影剂Echovist评估输卵管通畅性时，该方法再次显示出100%的敏感性和阴性预测值，但特异性达到77%，阳性预测值为70%。手术期间及术后均无明显并发症。
子宫输卵管超声造影有助于对不孕症的诊断和治疗的进一步程序做出决策。使用生理盐水评估子宫腔是首选方法。仅在理想的超声条件下才能评估输卵管通畅性。作为一种简单、安全且便宜的门诊方法，该方法在任何后续侵入性手术甚至子宫输卵管造影之前，对子宫腔和输卵管的生殖状况进行早期评估是可行的。
