| Objective:To explore the clinical application value of transvaginal ultrasound real-time three-dimensional hysterosalpingo-contrast sonography(RT-3D-HyCoSy)for tubal patency evaluation.Methods:A total of 109 patients with tubal infertility treated in obstetrics and gynecology department of our hospital from June 2016 to June 2018 were selected.They were divided into two groups:hysterosalpingo-contrast sonography(HyCoSy)group and hysterosalpingography(HSG)group.①In the HyCoSy group,the US GE company’s Voluson E8 multicolor Doppler ultrasonic diagnostic apparatus was used to evaluate the patency of the fallopian tubes of the patients respectively by RT-3D-HyCoSy and two-dimensional hysterosalpingo-contrast sonography(2D-HyCoSy).②In the HSG group,the Germany Siemens digital gastrointestinal machine was used for HSG examination to evaluate the patency of fallopian tubes.③Both groups received LC examination within one month after the end of contrast examination,and the diagnostic coincidence rate,consistency,sensitivity and specificity of the two methods for the diagnosis of tubal patency evaluation were analyzed with LC as the gold standard.④The two groups were followed up in 12 months to explore the clinical effect and application value of RT-3D-HyCoSy in evaluating fallopian tube patency.Results:1.There was no statistically significant difference between 2D-HyCoSy and RT-3D-HyCoSy in evaluating fallopian tube patency(x2=0.358,P=0.836).2.RT-3D-HyCoSy was more intuitive and accurate in diagnosing three-dimensional shape of fallopian tube,and the inspection results were significantly better than that of 2D-HyCoSy,and the difference between the two methods was statistically significant(x2=4.46,P=50.034).3.Taking LC as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and diagnostic coincidence rate of RT-3D-HyCoSy group were 81.13%,92.98%,91.49%,84.13%and 87.27%.The differences of the two methods’ test results were not statistically significant(x2=2.57,P=0.108).Kappa test was used for consistency,with Kappa=0.7460 and P<0.05,indicating that the results of RT-3D-HyCoSy and LC were highly consistent.Taking LC as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and diagnostic coincidence rate of HSG group were 76.74%,92.73%,89.19%,83.61%and 85.71%.The difference between HSG and LC was not statistically significant(x2=2.57,P=0.109).Kappa test was used for consistency,with Kappa=0.5050 and P<0.05,indicating that HSG and LC test results were moderately consistent.The comparison of the results between the two groups showed that the results of the tubal patency evaluation by RT-3D-HyCoSy were more consistent than HSG compared with the gold standard LC.4.According to the results of 12 months of follow-up after examination,the natural conception rate of the HyCoSy group and the HSG group were 46.6%and 27.5%.The pregnancy rate was significantly higher than that of the HSG group,and the difference was statistically significant(x2=4.47,P=0.034).Conclusion:1.Both 2D-HyCoSy and RT-3D-HyCoSy could evaluate the fallopian tube patency of female infertility patients,and there was no significant difference in diagnostic value.2.RT-3D-HyCoSy is more intuitive and accurate than 2D-HyCoSy in displaying three-dimensional shape of fallopian tube.3.Taking LC as the gold standard,the consistency,sensitivity,specificity and diagnostic coincidence rate of fallopian tube patency evaluated by RT-3D-HyCoSy were higher than HSG,and the differences were statistically significant.4.Natural conception rate of RT-3D-HyCoSy examination was significantly higher than that of HSG.5.RT-3D-HyCoSy has high safety,economy,speed,accuracy and high clinical effect and application value,which can be used as the first choice imaging method for clinical evaluation of fallopian tube patency. |
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