不孕症实时三维超声造影检查体系的临床应用

发布时间：2018-03-07 09:20

本文选题：不育　切入点：女性　出处：《中国介入影像与治疗学》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨经阴道三维超声自由解剖(Omni-View)技术、宫腔声学造影和子宫输卵管实时三维超声造影相结合的实时三维超声造影检查体系在不孕症诊断中的临床应用价值。方法回顾性分析246例因临床拟诊输卵管性不孕症接受实时三维超声造影检查体系检查的患者资料,其中56例同期接受宫腔镜检查并获病理结果,33例同期接受腹腔镜检查。结果 246例中,Omni-View成像检出宫腔粘连10例,子宫息肉15例,弓形子宫7例,不全纵隔术后2例。宫腔声学造影检出宫腔粘连50例,子宫息肉24例,内膜局部缺损2例。以病理结果为金标准,Omni-View技术诊断子宫息肉的敏感度、特异度、准确率分别为33.33%(6/18)、92.11%(35/38)、73.21%(41/56);宫腔声学造影诊断子宫息肉的敏感度、特异度、准确率分别为94.44%(17/18)、94.73%(36/38)、94.64%(53/56)。以病理结果为金标准,Omni-View技术诊断宫腔粘连的敏感度、特异度、准确率分别为25.00%(8/32)、91.67%(22/24)、53.57%(30/56),宫腔声学造影诊断宫腔粘连的敏感度、特异度、准确率分别为90.63%(29/32)、100%(24/24)、94.64%(53/56)。子宫输卵管实时三维超声造影与腹腔镜通染液检查对输卵管通畅程度判断的总符合率为86.36%(57/66),两种方法具有较高的一致性(Kappa=0.841,P0.001)。超声检查过程中,出现轻度不良反应84例,中度不良反应32例,均为非药物性不良反应,休息15~20min后症状均消失。结论通过实时三维超声造影检查体系可在一次系统检查中对宫腔输卵管进行全面评估,有助于临床不孕症的诊断。
[Abstract]:Objective to study the technique of Omni-View, which is dissected by transvaginal three-dimensional ultrasound. The clinical application value of real-time three-dimensional contrast-enhanced ultrasound system combined with uterine cavity contrast contrast and hysterosalpingography in the diagnosis of infertility. Methods 246 cases of fallopian tube failure due to clinical diagnosis were retrospectively analyzed. Data of patients with pregnancy undergoing real-time three-dimensional contrast-enhanced examination system, Among them 56 cases received hysteroscopy and 33 cases underwent laparoscopy simultaneously. Results 10 cases of intrauterine adhesion were detected by Omni-View imaging, 15 cases of uterine polyps, 7 cases of arcuate uterus. 50 cases of intrauterine adhesions, 24 cases of uterine polyps and 2 cases of local endometrial defects were detected by intrauterine sonography. The sensitivity and specificity of Omni-View technique for diagnosis of uterine polyps were determined by pathological results. The accuracy rates are 33.33 / 18 / 92.11 / 35 / 38 / 73.21 and 41 / 56 / 56 respectively. The sensitivity, specificity, and accuracy of intrauterine sonography in the diagnosis of uterine polyps are 94.4444 / 17 / 17 / 94.73 / 36 / 38 / 94.64 / 53 / 56.The sensitivity and specificity of Omni-View technique in the diagnosis of intrauterine adhesions are as follows:. The accuracy rates were 25.00 / 32 / 91.67 / 22 / 24 / 53.57 / 30 / 56, respectively. The sensitivity and specificity of intrauterine ultrasonography in the diagnosis of intrauterine adhesions. The accuracy rates were 90.63 / 32 / 100 and 24 / 24 / 94.64 / 53.53 / 56 respectively. The total coincidence rate for the determination of the degree of patency of fallopian tubes was 86.36% and 57 / 66, respectively. The two methods had a high consistency of 0.841% P0.001. During the process of ultrasonic examination, the total coincidence rate between the two methods was 86.36% or 57 / 66%. In the process of ultrasonic examination, there was a high consistency between the two methods in determining the patency of fallopian tubes. There were 84 cases of mild adverse reactions and 32 cases of moderate adverse reactions, all of which were non-drug adverse reactions. Conclusion the real-time three-dimensional contrast-enhanced imaging system can be used to evaluate the uterine cavity and fallopian tube in a systematic way, which is helpful for the diagnosis of clinical infertility.
【作者单位】：杭州市中医院超声医学科;杭州市中医院中医妇科;
【分类号】：R711.6;R445.1

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