经阴道子宫输卵管超声造影在不孕症患者中的应用研究
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摘要
目的分析经阴道3D子宫输卵管超声造影应用于不孕症的临床效果。方法选取2015年3月至2016年2月在浙江省中医院诊治的75例不孕症患者作为研究对象。其中原发性不孕症45例,继发性不孕症30例。所有患者均行经阴道子宫输卵管超声造影检查,重建3D图像并综合评估子宫腔结构和输卵管的通畅性。结果 75例患者共检查145条输卵管(5例患者因宫外孕切除一侧输卵管)。44例(58.7%)患者诊断为双侧输卵管通畅,19例(25.3%)患者诊断为输卵管通而不畅,12例(16.0%)患者诊断为输卵管阻塞。其中,2例患者合并子宫肌瘤,2例患者合并卵巢内膜异位囊肿,1例患者合并子宫腺肌症。结论经阴道3D子宫输卵管超声造影显示子宫结构和输卵管走行全面直观,是一种安全可行的不孕症影像学检查手段。
Objective To evaluate theefficacy of transvaginal 3D hysterosalping contrast sonography in the diagnosis of patients with infertility. Methods A total of 75 patients diagnosed as infertility from March 2015 to February 2016 at our hospital were enrolled in this study, including 45 patients with primary infertility and 30 patients with secondary infertility. All the patients underwent 3D hysterosalpingo-contrast sonography. The reconstructed 3D images were investigated to evaluate the structural abnormality of uterine cavity and the patency of fallopian tubes. Results Among the 75 patients, a total of 145 fallopian tubes were examined(5 patients underwent resection of one side of the fallopian tube due to ectopic pregnancy). There were 44 patients(58.7%) diagnosed as bilateral fallopian tube patency, 19 patients(25.3%) diagnosed as fallopian tube partially obstructed and 12 patients(16.0%) diagnosed as fallopian tube obstruction. In patients with tubal obstruction, there were 2 patients with uterine fibroids, 2 patients with ovarian endometriosis cyst, and a patient with uterine adenomyosis.Conclusions 3D transvaginal hysterosalping contrast sonography can visually demonstrate the morphology of fallopian tube and uterus, which can be used as a safe and feasible method for the assessment of fallopian tube patency and uterine malformation in patients with infertility.
Objective To evaluate theefficacy of transvaginal 3D hysterosalping contrast sonography in the diagnosis of patients with infertility. Methods A total of 75 patients diagnosed as infertility from March 2015 to February 2016 at our hospital were enrolled in this study, including 45 patients with primary infertility and 30 patients with secondary infertility. All the patients underwent 3D hysterosalpingo-contrast sonography. The reconstructed 3D images were investigated to evaluate the structural abnormality of uterine cavity and the patency of fallopian tubes. Results Among the 75 patients, a total of 145 fallopian tubes were examined(5 patients underwent resection of one side of the fallopian tube due to ectopic pregnancy). There were 44 patients(58.7%) diagnosed as bilateral fallopian tube patency, 19 patients(25.3%) diagnosed as fallopian tube partially obstructed and 12 patients(16.0%) diagnosed as fallopian tube obstruction. In patients with tubal obstruction, there were 2 patients with uterine fibroids, 2 patients with ovarian endometriosis cyst, and a patient with uterine adenomyosis.Conclusions 3D transvaginal hysterosalping contrast sonography can visually demonstrate the morphology of fallopian tube and uterus, which can be used as a safe and feasible method for the assessment of fallopian tube patency and uterine malformation in patients with infertility.
引文
[1] 许东峰,姜丽英,陈英,等.三维子宫输卵管超声造影对不孕症的诊断价值[J].东南大学学报,2013,32(2);227-229.
[2] 徐虹,汪龙霞,罗渝昆,等.子宫输卵管三维超声造影检查在不孕症诊断中的临床价值[J].中华医学超声杂志,2011,8(12):2578-2584.
[3] 卢虹,董军键,吴祖扬,等.三维子宫输卵管超声造影在临床中的应用[J].中国超声医学杂志,2013,29(11):1041-1043.
[4] 王莎莎,程琦,朱贤胜,等.经阴道实时三维子宫输卵管超声造影的临床应用[J].中华超声影像学杂志,2013,22(5):932-934.
[5] 李蕊,王琦.经阴道实时三维子宫输卵管超声造影的效果评价[J].中国病案,2014,15(10):79-80.
[6] 高学文,王军燕,汪龙霞,等.声诺维与双氧水子宫输卵管超声造影临床对照研究[J].中国超声医学杂志,2008,24(10):929-931.
[7] Hemed HO,Shahin AY,Elasmman AM.Hysterosal-pingocontrast sonography versus radiographic hesterosdalpingography in the evaluation of tubal patency[J].Int J Gynecol Obstet,2009,105:215-217.
[8] 王华,周琦,姜珏,等.二维与三维子宫输卵管超声造影对输卵管通畅性诊断价值的比较[J].实用妇产科杂志,2011,27(11):824-827.
[9] Zhou L,Zhang X,Chen X,et al.The value of three-dimensional hysteron-salpingo-contrast sonography with SonoVue in the assessment of tubal patency[J].Ultrasound Obstet Gynecol,2012,40:93-98.
[10] 李永奎,邓金龙,于小勇,等.子宫输卵管造影中双腔球囊导管顶端对输卵管显示的假阳性影响[J].临床放射学杂,2007,26(4):387-389.
[11] 蔡爱露,陈雁威,杨清,等.经阴道三维超声宫腔造影诊断先天性子宫畸形[J].中国超声医学杂志,2004,20(5):375-379.
[12] Savelli L,Pollastri P,Guerrini M,et al.Tolerability,side effects and complications of hysterosalping-contrast sonography (HyCoSy) [J].Fertil Steril,2009,92(4):1481-1486.
[2] 徐虹,汪龙霞,罗渝昆,等.子宫输卵管三维超声造影检查在不孕症诊断中的临床价值[J].中华医学超声杂志,2011,8(12):2578-2584.
[3] 卢虹,董军键,吴祖扬,等.三维子宫输卵管超声造影在临床中的应用[J].中国超声医学杂志,2013,29(11):1041-1043.
[4] 王莎莎,程琦,朱贤胜,等.经阴道实时三维子宫输卵管超声造影的临床应用[J].中华超声影像学杂志,2013,22(5):932-934.
[5] 李蕊,王琦.经阴道实时三维子宫输卵管超声造影的效果评价[J].中国病案,2014,15(10):79-80.
[6] 高学文,王军燕,汪龙霞,等.声诺维与双氧水子宫输卵管超声造影临床对照研究[J].中国超声医学杂志,2008,24(10):929-931.
[7] Hemed HO,Shahin AY,Elasmman AM.Hysterosal-pingocontrast sonography versus radiographic hesterosdalpingography in the evaluation of tubal patency[J].Int J Gynecol Obstet,2009,105:215-217.
[8] 王华,周琦,姜珏,等.二维与三维子宫输卵管超声造影对输卵管通畅性诊断价值的比较[J].实用妇产科杂志,2011,27(11):824-827.
[9] Zhou L,Zhang X,Chen X,et al.The value of three-dimensional hysteron-salpingo-contrast sonography with SonoVue in the assessment of tubal patency[J].Ultrasound Obstet Gynecol,2012,40:93-98.
[10] 李永奎,邓金龙,于小勇,等.子宫输卵管造影中双腔球囊导管顶端对输卵管显示的假阳性影响[J].临床放射学杂,2007,26(4):387-389.
[11] 蔡爱露,陈雁威,杨清,等.经阴道三维超声宫腔造影诊断先天性子宫畸形[J].中国超声医学杂志,2004,20(5):375-379.
[12] Savelli L,Pollastri P,Guerrini M,et al.Tolerability,side effects and complications of hysterosalping-contrast sonography (HyCoSy) [J].Fertil Steril,2009,92(4):1481-1486.