Exploration Of Clinical Comparisons Between Ultrasound Angiography And X-ray Lipiodol Angiography To Evaluate The Patency Of Oviduct

Infertility is an important illness issue which upsets many couples at reproductive age in every area even country globally.The prevalence rate varies from 7% to 10%.According to the statistics,the infertility trends to continuously rise over the recent years.In female infertility patients,tubal disease is the main etiology.In foreign countries,30%~35% are related to tubal factors,in China:50% are associated with tubal obstruction and narrowness,various causes(tubal hypoplasia,sequelae of pelvic inflammatory disease,endometriosis,chronic salpingitis and so on)causes tubal dysfunction or obstruction,which is the important factor affecting the oviduct infertility.Therefore,it is important to evaluate the patency of fallopian tube,whether the oviduct is abnormal is of great significance in the discussion of infertility etiology.To accurate evaluate the morphology and function of fallopian tube is also an important link to cure tubal infertility.Uterine oviduct 4D-SonoVue ultrasound can diagnose uterine cavity disease,tubal patency degree,lesion morphology and illness location.No wound,simple operation,low cost,long time-saving data,accurately evaluate the patency of fallopian tube are the keys to cure infertility and also provides an important accordance for clinical treatment.Therefore,uterine oviduct ultrasound angiography is an indispensable complement examination for tubal infertility,which is of great significance to the patients with tubal infertility.Objective:To investigate the ultrasonographic features of transvaginal uterine fallopian tube SonoVue angiography(4D-HyCoSy),and compare with the results of x-ray hysterosal-pingography(HSG).The results were analyzed by SPSS19.0 software,Diagnosis of tubal smoothness diagnostic value(diagnostic accuracy),consistency and positive,negative predictive value,specificity,sensitivity.The results showed that the effect of contrast-enhanced ultrasonogr-aphy and iodized oil on the diagnosis of tubal patency was analyzed,and the diagnosis of tubal smoothness was analyzed.The results were as follows:1.Clinical value.Methods:The study explores and discusses the transvaginal uterus oviduct SonoVue 4D ultrasound angiography(four-dimensional Hysterosalpingo contast sonography,4D-HyCoSy),uterine oviduct radiography(Hystero-salpinggraphy,HSG).Respectively compare with the results of hysteroscopy laparoscopy using SPSS19.0 software for statistical analysis,analyze the diagnosis value of the two methods to diagnose the patency of fallopian tube(the correct rate of diagnosis),consistency,specificity and sensitivity.Follow up and know the natural fertilization situation after 6 months,statistically analyze the successful pregnancy cases and various cases,analysze the effectiveness of uterine oviduct SonoVue ultrasound angiography in the diagnosis of patency of oviduct and explore the diagnosis significance and clinical values of uterine oviduct SonoVue 4D ultrasound angiography applied in evaluation of oviduct patency.Results:There are totally 98 cases of infertile patients,2 patients of them underwent unilateral salpingectomy or unilateral andnextectomy.58 cases of patients(114 oviducts)underwent the uterine oviduct 4D SonoVue ultrasound angiography: 17 patent oviducts,accounting for 14.9%(17/114),72 obstructive oviducts,accounting for 63.2%(72/114),25 narrow oviducts(stenosis),accounting for 21.9%(25/114).40 cases(80 oviducts)in the X ray lipiodol angiography:25 patent oviducts,accounting for 31.25%(25/80),47 obstructive oviducts,accounting for 58.75%(47/80),8 narrow oviducts,accounting for 10%(10/80).In laparoscope,35 patent oviducts(19 in the HyCoSy group and 16 in HSG group),128 obstructive oviducts(76 in HyCoSy group and 52 in HSG group),33 narrow oviducts(21 in the HyCoSy group and 12 in HSG group).According to the standard analysis of laparoscopy,HyCoSy group: sensitivity(%)=97.8%;specificity(%)=84.2%;accuracy(%)=92.2%.Group HSG: sensitivity(%)=88.5%;specificity(%)=81.3%;the accuracy(%)=83.8%.98 cases of tubal recanalization six months later,the recurrent pregnancy rate of HyCoSy group is higher than that of HSG group(P<0.05).Compare and analyze the accurate diagnosis rates of the 2 kinds of examination methods of the oviduct situation: the accurate diagnosis rate of the transvaginal uterus oviduct SonoVue 4D ultrasound angiography is obviously higher than that of oviduct angiography under X-ray,the differences were statistically significant(P<0.05).Compare the specificity and sensitivity of examination methods of 2 groups:the specificity and the sensitivity of the transvaginal uterus oviduct 4D-SonoVue ultrasound angiography for diagnosis of oviduct obstruction were both higher than those of oviduct angiography under X-ray,the differences were statistically significant(P<0.05).Conclusions:The ultrasound angiography is a new method to evaluate the patency of the oviduct.It has the advantages of relatively less trauma,safety,simple operation,high accuracy,low cost,good repeatability,long time preserved data and long term utilization.Compared with lipiodol X-ray,ultrasound angiography can timely observe flow of the angiography agent,diffusion into the uterine cavity,determine the patency of bilateral oviducts,know about the ovarian,uterus and pelvic cavity,and even specifically and sensitively detect the uterine cavity morphology,observe the uterine myometrium and ovary,etc.The most important is to have a certain treatment function of mild peritoneal adhesion and tubal patent degree;the time of pregnancy is not restricted.So the ultrasound angiography,increasingly popular and highly-appreciated,is now the main method which is the most widely-used and of the highest diagnosis value to evaluate the tubal patency.