Department of Obstetrics and Gynecology, Università degli Studi di Roma Tor Vergata, Rome, Italy.
Ultrasound Obstet Gynecol. 2013 Mar;41(3):328-35. doi: 10.1002/uog.11200.
To evaluate the feasibility of transvaginal hysterosalpingo-contrast sonography (HyCoSy) with new automated three-dimensional coded contrast imaging (3D-CCI) software in the evaluation of tubal patency and visualization of tubal course.
Patients undergoing HyCoSy with automated 3D-CCI software were evaluated prospectively. First, to evaluate the feasibility of 3D visualization of tubal course, we performed consecutive volume acquisitions while injecting SonoVue contrast agent. We then performed conventional two-dimensional (2D) real-time HyCoSy to confirm tubal patency status by detection of saline and air bubbles moving through the Fallopian tubes and around the ovaries. We also evaluated visualization with CCI of the contrast agent around the ovaries, side effects and pain during and after the procedure, by visual analog scale (VAS) (ranging from 0 to 10, with 0 corresponding to no pain and 10 corresponding to maximum pain).
A total of 126 patients (252 tubes) underwent 3D-CCI HyCoSy followed by 2D real-time HyCoSy. According to the final 2D real-time evaluation, bilateral tubal patency was observed in 111 patients, bilateral tubal occlusion in four patients and unilateral tubal patency in 11 patients. The concordance rate for tubal patency status between the first 3D volume acquisition and the final 2D real-time evaluation was 84% and that between the second 3D volume acquisition and the final 2D real-time evaluation was 97%. A pain score >5 on VAS was recorded in 58% of patients during the procedure, but a pain score ≤ 5 was recorded in 85.7% of patients immediately after the procedure.
HyCoSy with automated 3D-CCI technology retains the advantages of conventional 2D HyCoSy while overcoming the disadvantages. 2D HyCoSy is highly observer-dependent and is only accurate in the hands of experienced investigators; by obtaining a volume of the uterus and tubes, automated 3D volume acquisition permits visualization of the tubes in the coronal view and of the tubal course in 3D space, and should allow less experienced operators to evaluate tubal patency status relatively easily.
评估新型自动化三维编码对比成像（3D-CCI）软件经阴道子宫输卵管造影（HyCoSy）在评估输卵管通畅性和输卵管走行可视化方面的可行性。
前瞻性评估接受自动化 3D-CCI 软件 HyCoSy 的患者。首先，为了评估输卵管走行三维可视化的可行性，我们在注射声诺维造影剂的同时连续进行容积采集。然后，我们进行传统的二维（2D）实时 HyCoSy，通过检测通过输卵管和卵巢周围的生理盐水和气泡来确认输卵管通畅状态。我们还通过视觉模拟量表（VAS）（范围从 0 到 10，0 表示无痛，10 表示最大疼痛）评估 CCI 对卵巢周围造影剂的可视化、副作用以及手术过程中和手术后的疼痛。
共有 126 名患者（252 条输卵管）接受了 3D-CCI HyCoSy 检查，随后进行了 2D 实时 HyCoSy 检查。根据最终的 2D 实时评估，111 名患者双侧输卵管通畅，4 名患者双侧输卵管阻塞，11 名患者单侧输卵管通畅。首次 3D 容积采集与最终 2D 实时评估的输卵管通畅状态一致性率为 84%，第二次 3D 容积采集与最终 2D 实时评估的一致性率为 97%。在手术过程中，58%的患者 VAS 疼痛评分>5，但手术后 85.7%的患者 VAS 疼痛评分≤5。
自动化 3D-CCI 技术的 HyCoSy 保留了传统 2D HyCoSy 的优势，同时克服了其缺点。2D HyCoSy 高度依赖观察者，只有经验丰富的研究人员才能准确进行；通过获取子宫和输卵管的容积，自动化 3D 容积采集允许在冠状视图中可视化输卵管，并在 3D 空间中可视化输卵管走行，并且应该允许经验较少的操作人员相对容易地评估输卵管通畅状态。
