宫腔压力测量在四维子宫输卵管超声造影中的应用价值

Application of uterine pressure measurement in four-dimensional hysterosalpingo-contrast sonography

关键词:  宫腔压力  输卵管通畅性  子宫输卵管超声造影

Key words:  uterine pressure  tubal patency  hysterosalpingo-contrast sonography

摘要:

目的　通过在四维子宫输卵管超声造影（4D-HyCoSy）中宫腔压力的测量，得出具体的量化指标，使其诊断更加精确。方法　对行4D-HyCoSy的68例患者，进行实时压力监测，对其宫腔峰值压力、输卵管完全显影压力等进行比较，绘制ROC曲线，确定压力截断值。结果　通过对宫腔峰值压力的比较，将输卵管通畅性分为：（1）双侧通畅；（2）双侧不完全通畅；（3）一侧阻塞+一侧通而不畅；（4）双侧阻塞。计算压力截断值:“双侧通畅”和“双侧不完全通畅”为34.50 kPa，“双侧不完全通畅”和“一侧阻塞+一侧通而不畅”为42.25 kPa，“一侧阻塞+一侧通而不畅”和“双侧阻塞”为56.75 kPa。为进一步鉴别“双侧不完全通畅”组中三种情况，对其输卵管完全显影时的宫腔压力进行比较，显示差异有统计学意义，并以26.75 kPa作为鉴别“通畅”和“通而不畅”输卵管的压力截断值。结论　在4D-HyCoSy中，宫腔压力值可作为判断输卵管通畅性的量化指标，其压力值大小与输卵管的通畅性有关。

Abstract:

Objective The uterine pressure measurement in 4D-HyCoSy can provide a quantitative index to make the diagnosis more accurate. Methods Real-time pressure monitoring was performed on 68 patients under 4D-HyCoSy.The peak pressure of uterine cavity and the pressure after complete develop of fallopian tube were compared. ROC curve was created to determine the pressure cutoff value. Results Based on the peak pressure of uterine cavity, tubal patency could be divided into (1)bilateral open (2)bilateral incomplete open (3)one side obstructed+ one side passable(4)bilateral obstructed. Pressure cutoff values with“bilateral open” and “bilateral incomplete open” was 34.50 kPa, “bilateral incomplete open” and “one side obstructed+one side passable” was 42.25 kPa, “one side obstructed+ one side passable” and “bilateral obstructed” was 56.75 kPa.In order to identify the three kinds of “bilateral incomplete open”, the pressure was further analyzed after when they were completely developed and there was significant difference. The pressure cutoff value was 26.75 kPa. Conclusion In 4D-HyCoSy,uterine pressure can be used as a quantitative index to judge the tubal patency, and the pressure is correlated withtubal patency.