Steck T, Würfel W, Becker W, Albert P J
Department of Obstetrics and Gynaecology, University of Würzburg, FRG.
Hum Reprod. 1991 Oct;6(9):1186-91. doi: 10.1093/oxfordjournals.humrep.a137510.
Spontaneous migration of a radionuclide tracer from the vagina to the peritoneum may be visualized by scintigraphic imaging (hysterosalpingoscintigraphy, HSS). A prospective study was designed to evaluate diagnostic criteria for normal tubal passage of a control group (n = 7) and to establish the predictive value of the HSS technique in defining functional deficiency in anatomically patent tubes. In 56 patients with tubal and unexplained infertility, a comparison between the results of the tracer migration study and of contrast hysterosalpingography and laparoscopy was made. The overall correlation was 65%. Clearly discrepant results (i.e. an abnormal migration pattern in anatomically patent tubes) were recorded in 18% and were positively, yet not significantly associated with tubal adhesive disease and with a history of tubal microsurgery. Interpretation of scans was equivocal in another 18% of patients due to undetectable ascension of the tracer to the uterus. It is suggested that the radionuclide is moved forward by the same passive transport processes which are concerned with support of the migration of spermatozoa to the ovum, and that failure of tubal migration of the tracer may render patients eligible for in-vitro fertilization/embryo transfer treatment.
放射性核素示踪剂从阴道自发迁移至腹膜的过程可通过闪烁成像（子宫输卵管闪烁造影术，HSS）进行可视化观察。一项前瞻性研究旨在评估对照组（n = 7）输卵管通畅的诊断标准，并确定HSS技术在定义解剖结构正常的输卵管功能缺陷方面的预测价值。对56例输卵管性及不明原因不孕症患者，对比了示踪剂迁移研究结果与子宫输卵管造影和腹腔镜检查结果。总体相关性为65%。18%的患者出现明显不一致的结果（即解剖结构正常的输卵管出现异常迁移模式），且与输卵管粘连疾病及输卵管显微手术史呈正相关，但无显著关联。另外18%患者的扫描结果难以判断，原因是示踪剂无法检测到向子宫的上升。研究表明，放射性核素通过与支持精子向卵子迁移相同的被动转运过程向前移动，示踪剂输卵管迁移失败可能使患者适合体外受精/胚胎移植治疗。
