Jin Yi, Huang Wendi, Qv Qinhong, Liu Shuling
Department of Ultrasound Imaging, the First People's Hospital of Wenling, Wenling City, Zhejiang Province, People's Republic of China.
Int J Womens Health. 2022 Apr 21;14:583-591. doi: 10.2147/IJWH.S359467. eCollection 2022.
Intravasation during transvaginal 4-dimensional hysterosalpingo-contrast sonography (TVS 4D-HyCoSy) may lead to false-negative results in tubal patency evaluation. Although the influencing factors associated with intravasation have been investigated, some factors are only identified during 4D-HyCoSy, thus currently no studies on preventing intravasation. However, several preprocedural features can be collected in advance, which may be valuable in predicting intravasation.
The purpose of this study is to establish a nomogram incorporating the preprocedural features to predict the risk of intravasation before TVS 4D-HyCoSy.
The data of 276 infertile women with patent fallopian tubes were analyzed retrospectively. They were assigned to the study group (n = 62) and the control group (n = 214) according to the development of intravasation. The preprocedural characteristics were collected to investigate the predictors independently associated with intravasation, which were then served as the construction of a nomogram. The performance of the nomogram was verified internally.
History of uterine curettage ( = 2.341, = 0.009), endometrial thickness ( = 0.587, < 0.001), and examination schedule ( = 0.790, = 0.024) were found to be the independent influencing factors associated with intravasation. The established nomogram incorporating these preprocedural features was useful for predicting the risk of intravasation prior to 4D-HyCoSy. It yielded net benefits when the predicted probability was less than 50%.
The nomogram incorporating the preprocedural characteristics achieved a net benefit for clinical decision-making when the estimated risk was less than 50%. It is recommended to change the examination schedule for patients with an estimated risk greater than 50% and perform 4D-HyCoSy when the risk is less than 50%.
经阴道四维子宫输卵管超声造影检查（TVS 4D-HyCoSy）期间的血管内造影可能会导致输卵管通畅性评估出现假阴性结果。尽管已经对与血管内造影相关的影响因素进行了研究，但有些因素仅在4D-HyCoSy期间才能确定，因此目前尚无关于预防血管内造影的研究。然而，一些术前特征可以提前收集，这可能对预测血管内造影有价值。
本研究的目的是建立一个包含术前特征的列线图，以预测TVS 4D-HyCoSy前血管内造影的风险。
回顾性分析276例输卵管通畅的不孕妇女的数据。根据血管内造影的发生情况，将她们分为研究组（n = 62）和对照组（n = 214）。收集术前特征以研究与血管内造影独立相关的预测因素，然后将这些因素用于构建列线图。列线图的性能在内部得到验证。
发现刮宫史（ = 2.341， = 0.009）、子宫内膜厚度（ = 0.587， < 0.001）和检查时间安排（ = 0.790， = 0.024）是与血管内造影相关的独立影响因素。纳入这些术前特征的既定列线图有助于预测4D-HyCoSy前血管内造影的风险。当预测概率小于50%时，它产生了净效益。
纳入术前特征的列线图在估计风险小于50%时为临床决策带来了净效益。建议对估计风险大于50%的患者更改检查时间安排，并在风险小于50%时进行4D-HyCoSy。
