Shah S M H, Towobola O A, Masihleho M
Department of Obstetrics and Gynaecology, Ga-rankuwa Hospital, Medical University of Southern Africa Pretoria, Republic of South Africa.
East Afr Med J. 2005 Sep;82(9):457-62. doi: 10.4314/eamj.v82i9.9336.
To evaluate and compare the diagnostic value of hysterosalpingography (HSG) and laparoscopic chromopertubation (LCP), in the diagnosis of fallopian tube patency.
A comparative prospective study.
The infertility clinic of the Department of Obstetrics and Gynaecology, Ga-Rankuwa hospital (Medical University of Southern Africa), Pretoria, South Africa.
Fifty patients were initially diagnosed with either unilateral or bilateral tubal block using HSG. Six to eight weeks later the same women were subjected to LCP to assess tubal patency.
Diagnostic accuracy of HSG to establish tubal patency, site of occlusion and the presence of other pathologies was compared with results obtained after laparoscopic chromopertubation (LCP).
Hysterosalpingography diagnosed bilateral proximal, bilateral distal and mixed (i.e. one side proximal and the other distal) tubal occlusion in 15(40.5%); 13(35.1%) and five (13.5%) cases respectively. Diagnostic laparoscopy confirmed the above sites of occlusion in nine (24.3%), 71(45.9%) and three (8.1%) cases. Laparoscopy detected bilateral tubal patience in three (8.1%) patients, in whom HSG had diagnosed tubal occlusion. USG was able to detect peritubal Adhesion in only four (10.8%) patients as compared with 11 patients when LCP procedure was used. In comparison with HCP, hysterosalpingography demonstrated 70% specificity for accurately diagnosing proximal tubal occlusion.
On a comparative scale, HSG demonstrated reduced positive predictive value especially for bilateral proximal tubal occlusion. However, in spite of its relatively limited value for accurately identifying tubal patency, HSG should still serve as a useful primary investigation.
评估并比较子宫输卵管造影术（HSG）和腹腔镜染色输卵管通畅检查（LCP）在诊断输卵管通畅性方面的价值。
一项比较性前瞻性研究。
南非比勒陀利亚加兰夸医院（南非医学大学）妇产科不孕症门诊。
50例最初经HSG诊断为单侧或双侧输卵管阻塞的患者。6至8周后，对这些女性进行LCP以评估输卵管通畅情况。
将HSG确定输卵管通畅性、阻塞部位及其他病变的诊断准确性与腹腔镜染色输卵管通畅检查（LCP）的结果进行比较。
子宫输卵管造影术分别诊断出双侧近端、双侧远端及混合性（即一侧近端另一侧远端）输卵管阻塞的病例为15例（40.5%）、13例（35.1%）和5例（13.5%）。诊断性腹腔镜检查证实上述阻塞部位的病例分别为9例（24.3%）、71例（45.9%）和3例（8.1%）。腹腔镜检查发现3例（8.1%）患者双侧输卵管通畅，而HSG诊断为输卵管阻塞。超声检查仅能检测到4例（10.8%）患者的输卵管周围粘连，而LCP检查能检测到11例。与LCP相比，子宫输卵管造影术对准确诊断近端输卵管阻塞的特异性为70%。
在比较中，HSG显示出较低的阳性预测值，尤其是对双侧近端输卵管阻塞。然而，尽管其在准确识别输卵管通畅性方面价值相对有限，但HSG仍应作为一项有用的初步检查。
