经阴道实时三维子宫输卵管超声造影评估输卵管通畅性时误诊的原因
Causes of misdiagnosis in assessing tubal patency by transvaginal real-time three-dimensional hysterosalpingo-contrast sonography.
作者信息
Liang Na, Wu Qing-Qing, Li Jing-Hua, Gao Feng-Yun, Sun Fu-Li, Guo Cui-Xia
机构信息
. Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital of Capital Medical University, Beijing 100026, China.
出版信息
Rev Assoc Med Bras (1992). 2019 Sep 12;65(8):1055-1060. doi: 10.1590/1806-9282.65.8.1055.
OBJECTIVE
This study aims to investigate the causes of misdiagnosis in assessing tubal patency by transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy), in order to improve the diagnostic efficiency of TVS RT-3D-HyCoSy.
METHODS
A total of 162 oviducts of 83 infertility patients were examined by TVS RT-3D-HyCoSy. These results were compared with the gold standard for laparoscopic dye studies, and the misdiagnosed cases were analyzed.
RESULTS
TVS RT-3D-HyCoSy revealed that 68 oviducts were unobstructed and 94 obstructed. The results for the 144 oviducts were in line with the gold standard, while those for 18 oviducts were not. The accuracy rate of the TVS RT-3D-HyCoSy was 88.9%, and the misdiagnosis rate was 11.1%. The main causes of misdiagnosis included contrast medium countercurrent and diffusion, oviduct spasm, abnormal shape or position of the oviduct, pelvic adhesion, and poor imaging operation.
CONCLUSION
TVS RT-3D-HyCoSy can well-evaluate tubal patency, and understand and improve the cause of misdiagnosis. Furthermore, the diagnostic efficiency of TVS RT-3D-HyCoSy can still be further improved.
目的
本研究旨在探讨经阴道实时三维子宫输卵管超声造影（TVS RT-3D-HyCoSy）评估输卵管通畅性时误诊的原因，以提高TVS RT-3D-HyCoSy的诊断效率。
方法
对83例不孕症患者的162条输卵管进行TVS RT-3D-HyCoSy检查。将这些结果与腹腔镜染料检查的金标准进行比较，并对误诊病例进行分析。
结果
TVS RT-3D-HyCoSy显示68条输卵管通畅，94条阻塞。144条输卵管的结果与金标准相符，18条输卵管的结果不符。TVS RT-3D-HyCoSy的准确率为88.9%，误诊率为11.1%。误诊的主要原因包括造影剂逆流和扩散、输卵管痉挛、输卵管形态或位置异常、盆腔粘连以及成像操作不佳。
结论
TVS RT-3D-HyCoSy能够很好地评估输卵管通畅性，了解并改善误诊原因。此外，TVS RT-3D-HyCoSy的诊断效率仍可进一步提高。
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