Objective To evaluate the clinical value of transvaginal four-dimensional hysterosalpingo-constrast sonography ( TVS 4D-HyCoSy) in the diagnosis of infertility. Methods Totally 152 patients underwent TVS 4D-HyCoSy with Sonovue to observe the tubal patency. Among them, 50 patients accepted laparoscopic dye test, and the results were analyzed. Results Among 304 tubes, TVS 4D-HyCoSy showed that there were 145 unobstructed tubes, 64 obstructed tubes, and 95 partially passable tubes. There were 25 cases diagnosed with other lesions. Laparoscopic dye test had high consistency with TVS 4D-HyCoSy in judging fallopian tube patency (κ =0. 847,P<0. 01). Conclusion TVS 4D-HyCoSy can demonstrate dynamic morphological features of fallopian tube, accurately assess tubal patency, and diagnose uterine malformation and lesion. It will be a necessary examination method in diagnosis of infertility.%目的：探讨经阴道子宫输卵管四维超声造影在不孕症诊断中的临床价值。方法采用Sono Vue造影剂对152例不孕症患者行TVS 4D-HyCoSy,动态观察输卵管通畅性,其中50例患者接受了腹腔镜下通染液检查,并比较评价结果。结果152例患者304条输卵管四维超声造影显示输卵管通畅145条,完全阻塞64条,通而不畅95条；同时检出输卵管外病变25例。50例子宫输卵管超声造影与腹腔镜通液结果比较两种方法在判断输卵管通畅性方面一致性高(κ=0.847,P<0.01)。结论经阴道子宫输卵管四维超声造影(TVS 4D-HyCoSy)可动态显示子宫及输卵管形态,不仅能准确评价输卵管通畅情况,还可诊断子宫畸形及宫腔病变,有望成为不孕症诊断中必不可少的检查方法。
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