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经阴道二维基础超声造影联合超声下输卵管通液术对输卵管伞端形态和功能的评估价值。

The Performance of Transvaginal Two-Dimensional Fundamental Sonosalpingography Combined with Saline Infusion Pelvic Sonosalpingography for Assessing Fimbrial Part's Morphology and Function of the Fallopian Tubes.

机构信息

Department of Ultrasonography, Zhejiang Provincial People's Hospital, Hangzhou, China.

Department of Ultrasound, Zhejiang Provincial TongDe Hospital, Hangzhou, China.

出版信息

J Ultrasound Med. 2022 Jan;41(1):41-50. doi: 10.1002/jum.15677. Epub 2021 Mar 3.

Abstract

OBJECTIVES

The purpose of this study was to evaluate the diagnostic efficacy of transvaginal two-dimensional fundamental sonosalpingography (2D-FS) combined with saline infusion pelvic sonosalpingography (SIPS) for assessing fimbrial part's morphology and function of the fallopian tubes.

METHODS

One hundred and sixty-nine cases underwent 2D-FS combined with SIPS. Among them, 18 cases received laparoscopy and dye test (LDT) within 3 months after the examination and the results were regarded as reference standard.

RESULTS

Excluding proximal or middle segment obstructed tubes, the remaining fimbrial parts' display rate by using 2D-FS combined with SIPS was 75.1%. According to the ultrasonic appearance, the fimbrial parts were classified into 4 types: normal, abnormal, suspected abnormal, and unclassifiable. Normal fimbrial parts accounted for 73.8% when the tubes were patent; abnormal fimbrial parts accounted for 74.1% when the tubes were partial obstructed; all became abnormal when the tubes were distal complete obstructed. The fimbrial parts which had been classified by 2D-FS combined with SIPS were compared with LDT further. This combination's accuracy (ACC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and Youden's index (YI) were 86.4, 87.5, 85.7, 77.8, 92.3, and 0.73%, respectively. The result of consistency analysis showed the combination was essentially consistent with LDT result (Kappa = 0.713).

CONCLUSION

2D-FS combined with SIPS can be a preferred method for assessment of the fimbrial part's morphology and function, with its advantages of non-invasive, intuition, and accuracy. This combination could provide an objective imaging basis for choosing clinical treatment strategies and predicting prognosis.

摘要

目的

本研究旨在评估经阴道二维基础声输卵管造影(2D-FS)联合盐水灌注盆腔声输卵管造影(SIPS)对评估输卵管伞部形态和功能的诊断效能。

方法

169 例患者行 2D-FS 联合 SIPS 检查。其中,18 例患者在检查后 3 个月内行腹腔镜下染料试验(LDT),并将其结果作为参考标准。

结果

排除近端或中段阻塞的输卵管后,2D-FS 联合 SIPS 对输卵管伞部的显示率为 75.1%。根据超声表现,输卵管伞部可分为 4 种类型:正常、异常、疑似异常和无法分类。当输卵管通畅时,正常输卵管伞部占 73.8%;当输卵管部分阻塞时,异常输卵管伞部占 74.1%;当输卵管远端完全阻塞时,所有输卵管伞部均表现为异常。进一步将 2D-FS 联合 SIPS 分类的输卵管伞部与 LDT 进行比较。该联合检查的准确性(ACC)、敏感度(SEN)、特异度(SPE)、阳性预测值(PPV)、阴性预测值(NPV)和约登指数(YI)分别为 86.4%、87.5%、85.7%、77.8%、92.3%和 0.73%。一致性分析结果显示,该联合检查与 LDT 结果基本一致(Kappa=0.713)。

结论

2D-FS 联合 SIPS 可作为评估输卵管伞部形态和功能的首选方法,具有无创、直观、准确的优点。该联合检查可为选择临床治疗策略和预测预后提供客观的影像学依据。

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