Lindheim S R, Sauer M V
Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Int J Gynaecol Obstet. 1998 Jan;60(1):47-50. doi: 10.1016/s0020-7292(97)00237-3.
To compare the results of sonohysterography (SHG) for imaging of the uterine cavity to hysterosalpingogram (HSG) and hysterscopy (HSC) in order to assess its clinical utility for recipients of donated oocyte.
From January 1996 to December 1996, we evaluated all patients (n = 50) referred for ovum donation using SHG and compared the results with HSG obtained within 6 months of SHG. Patients having either an abnormal SHG of HSG underwent HSC for confirmation and treatment. SHG was routinely performed during the early follicular phase using 10 cc saline instilled through an intracervical H-S catheter with concurrent vaginal sonography.
Pathology was observed and confirmed in 19 cases (38%) including polyps (n = 10, 52.6%), submucosal myomas (n = 7, 36.8%), intrauterine adhesions (n = 1, 5.3%) and bicornuate uterus (n = 1, 5.3%). SHG and HSG were concordant in 46 cases (95.8%) of which in 29 (60.4%) a normal cavity was observed, while four studies (8%) did not agree. Two polyps were missed on HSG, while two SHGs incorrectly diagnosed a calcified myoma and an endometrial fold. Using HSC for definitive identification, the accuracy of SHG was 90%, and similar to HSG.
SHG appears both sensitive and highly predictive for evaluating pathology of the endometrial cavity and appears to be as effective as HSG. Advantages of SHG include improved imaging or uterine pathology, cost, greater patient comfort and the avoidance of radiation. Routine SHG of recipients uncovered a high incidence of abnormalities in older women and underscores the need to evaluate the uterine cavity prior to ovum donation.
比较子宫声学造影（SHG）、子宫输卵管造影（HSG）和宫腔镜检查（HSC）对宫腔成像的结果，以评估其在卵母细胞捐赠受者中的临床应用价值。
1996年1月至1996年12月，我们对所有转诊进行卵子捐赠的患者（n = 50）进行了子宫声学造影评估，并将结果与子宫声学造影后6个月内进行的子宫输卵管造影结果进行比较。子宫声学造影或子宫输卵管造影异常的患者接受宫腔镜检查以进行确诊和治疗。子宫声学造影通常在卵泡早期进行，通过宫颈H-S导管注入10 cc生理盐水，并同时进行阴道超声检查。
19例（38%）观察到并确诊有病变，包括息肉（n = 10，52.6%）、黏膜下肌瘤（n = 7，36.8%）、宫腔粘连（n = 1，5.3%）和双角子宫（n = 1，5.3%）。子宫声学造影和子宫输卵管造影在46例（95.8%）中结果一致，其中29例（60.4%）观察到宫腔正常，而四项检查结果（8%）不一致。子宫输卵管造影漏诊了两个息肉，而两次子宫声学造影错误地诊断了一个钙化肌瘤和一个子宫内膜皱襞。通过宫腔镜检查进行最终确诊，子宫声学造影的准确率为90%，与子宫输卵管造影相似。
子宫声学造影在评估子宫内膜腔病变方面似乎既敏感又具有高度预测性，并且似乎与子宫输卵管造影一样有效。子宫声学造影的优点包括改善宫腔病变成像、成本低、患者舒适度更高以及避免辐射。对受者进行常规子宫声学造影发现老年女性异常发生率较高，强调了在卵子捐赠前评估宫腔的必要性。
