不孕症女性三维子宫输卵管造影联合阴道二维超声的诊断意义

摘要 目的：探讨不孕症女性三维子宫输卵管造影联合阴道二维超声的诊断意义。方法：2019年3月至2020年10月选择在西安医学院第二附属医院和陕西省人民医院诊治的不孕症女性患者90例，所有患者都给予三维子宫输卵管造影联合阴道二维超声检查，记录成像质量与疼痛情况。以X线子宫输卵管造影为金标准，判断诊断价值。结果：检查过程中三维超声造影患者的疼痛评分高于二维超声，对比差异无统计学意义(P>0.05)。三维超声造影的成像质量优良率为100.0 %（90/90），高于二维超声的93.3 %（84/90），对比差异有统计学意义(P<0.05)。在90例患者中，三维超声造影判断为卵巢周围组织弥散1级59例，2级16例，3级10例，4级5例。三维子宫输卵管造影联合阴道二维超声判断为输卵管通畅55例，通而不畅25例，阻塞10例。X线子宫输卵管造影判断为输卵管通畅53例，通而不畅26例，阻塞11例，三维子宫输卵管造影联合阴道二维超声诊断的准确性为96.7 %(87/90)。结论：三维子宫输卵管造影联合阴道二维超声在不孕症女性的应用并不会增加患者疼痛，且能提高成像质量，也有利于合理评价与判断患者的输卵管通畅情况。

Diagnostic Significance of Three-dimensional Hysterosalpingography Combined with Two-dimensional Vaginal Ultrasound in Infertile Women

ABSTRACT Objective: To explore the diagnostic significance of three-dimensional hysterosalpingography combined with two-dimensional vaginal ultrasound in women with infertility. Methods: From March 2019 to October 2020, 90 cases of female patients with infertility diagnosed and treated in Second Affiliated Hospital of Xi''an Medical College and Shaanxi Provincial People''s Hospital were selected as the research objects. All patients were given three-dimensional hysterosalpingography combined with two-dimensional vaginal ultrasound, recorded the imaging quality and pain. X-ray hysterosalpingography was used the gold standard to judge the diagnostic value. Results: During the examination, the pain score of patients with three-dimensional contrast-enhanced ultrasound was higher than that of two-dimensional ultrasound, and compared the difference were not statistically significant(P>0.05). The excellent and good imaging quality rate of three-dimensional contrast-enhanced ultrasound is 100.0 %(90/90), which is higher than that of two-dimensional ultrasound of 93.3 % (84/90). The difference is statistically significant(P<0.05). In the 90 patients, the three-dimensional contrast-enhanced ultrasonography judged that the periovarian tissue were diffused in 59 cases at grade 1, 16 cases in grade 2, 10 cases in grade 3, and 5 cases in grade 4. Three-dimensional hysterosalpingography combined with two-dimensional vaginal ultrasound judged that the fallopian tubes were unobstructed in 55 cases, unobstructed in 25 cases, and obstructed in 10 cases. X-ray hysterosalpingography determined that the fallopian tubes were unobstructed in 53 cases, unobstructed in 26 cases, and obstructed in 11 cases. The diagnostic accuracy of three-dimensional hysterosalpingography combined with vaginal two-dimensional ultrasound was 96.7 %(87/90). Conclusion: The application of three-dimensional hysterosalpingography combined with two-dimensional vaginal ultrasound in infertile women will not increase the patient''s pain, and can improve the imaging quality, and is also conducive to the reasonable evaluation and judgment of the patient''s tubal patency.