| Objective: In recent years,Transvaginalultrasound real time three-dimensional Hysterosalping constrast sonography(TVS RT 3D-Hy Co Sy)has been used to evaluate tubal patency in patients with infertility.However,it cannot provide more accurate diagnostic information in terms of uterine cavity lesions,and the diagnosis of pelvic adhesions is rarely reported.In this study,TVS RT 3D-Hy Co Sy was combined with saline solution infution sonohysterography(SIS)to investigate the diagnostic value of tube patency,uterine cavity lesions,and pelvic adhesions in patients with infertility,providing a more comprehensive and objective diagnosis of the cause of infertility.Methods: 1.66 infertility patients were chosen in Fujian Provincial Hospital from January 2016 to December 2017,who would be operated for both Hysteroscopy(HS)and Laparoscopic surgery(LPS).Pre-operation,they were examined by TVS RT-3DHy Co Sy combined with SIS.2.We compared the diagnostic results of tubal patency of TVS RT 3D Hy Co Sy combined with SIS and LPS,analyzed diagnosis sensitivity,specificity,accuracy,and Kappa value.We compared the diagnostic results of TVS RT 3D-Hy Co Sy combined with SIS and LPS to unobstructed tubes,partially passable tubes,proximal obstructed tubes,distal obstructed tubes,hydrosalpinx.66 patients of TVS RT-3D-Hy Co Sy combined with SIS divided into two groups: uterine cavity lesions and no uterine cavity lesionsaccording to hysteroscopy(HS),We compared the results of TVSRT 3D-Hy Co Sy and TVS RT 3D-Hy Co Sy combined with SIS in the diagnosis of uterine cavity lesions and analyzed the diagnostic efficacy of the two methods.66 patients of TVS RT-3DHy Co Sy combined with SIS dividedinto two groups: pelvic adhesions and no pelvic adhesions according to LPS,We compared the results of TVS and TVS RT 3D-Hy Co Sy combined with SIS in the diagnosis of pelvic adhesions,and analyzed the diagnostic efficacy of the two methods.Results: 1.Comparing the twomethods of TVS RT-3D-Hy Co Sy with SIS and LPS in diagnosing tubal patency Taking LPS as the gold standard,The sensitivity,specificity and acurracy of in diagnosing tubal patency were 93.05%,88.33%,90.90%.The Kappa value of the two methods in tubal patency was 0.816,P<0.001.Taking LPS as the gold standard,the sensitivity,specificity,accuracy,and Kappa value of unobstructed tubes,partially passable tubes,proximal obstructed tubes,distal obstructed tubes,hydrosalpinx were 88.33%,93.05%,90.90%,0.816;78.26%,91.74%,89.39%,0.655;84.21%,96.46%,94.69%,0.798;80.00%,97.05%,93.18%,0.799;85.71%,100%,97.72%,0.910.2.Comparing the two methods of TVS RT-3D-Hy Co Sy with SIS and TVS RT-3DHy Co Sy in diagnosing uterine cavity lesions Taking HS as the gold standard,The sensitivity,specificity and acurracy of TVS RT-3D-Hy Co Sy combined with SIS diagnosing uterine cavity lesions were89.65%,97.29%,93.93%,77.77%,68.75%,71.21%.The sensitivity,specificity and acurracy of TVS RT-3D-Hy Co Sy diagnosing uterine cavity lesions were 48.27%,89.18%,71.21%.The specificity difference between the two methods was no significant(P>0.05).The sensitivity and accuracy difference between the two methods were statistically significant(P < 0.05).3.Comparing the twomethods of TVS RT-3D-Hy Co Sy with SIS and TVSin diagnosing pelvic adhesions Taking LPS as the gold standard,The results of the diagnosis consistency of the two methods in pelvic adhesions were TVS RT-3D-Hy Co Sy with SIS: Kappa=0.758,P<0.001,TVA:Kappa=0.517,P<0.001.The sensitivity,specificity and acurracy of TVS RT-3D-Hy Co Sy combined with SIS diagnosing pelvic adhesions were85.71%,90.32%,87.87%.The sensitivity,specificity and acurracy of TVS diagnosing pelvic adhesions were 71.42%,80.64%,78.78%.The sensitivity,specificity and accuracy difference between the two methods were no significant(P>0.05).Conclusion 1.TVS RT-3D-Hy Co Sy combined with SIS was a safe and effective method to be used in evaluating tubal patency.TVS RT 3D-Hy Co Sy combined with SIS had alow accuracy in diagnosis of partially passable tubes,and the accuracy of diagnosis of hydrosalpinx was almost the same as that of laparoscopy.2.TVS RT 3D-Hy Co Sy combined with SIS could improve the accuracy of diagnosis in uterine cavity lesions.3.TVS RT 3D-Hy Co Sy combined with SIS could provide more diagnostic information for pelvic adhesions. |
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