Value Of Contrast-enhanced Ultrasonography In Diagnosis And Treatment Of Fallopian Tube Infertility

Part one Value of Contrast-enhanced Ultrasonography in Diagnosis tubal patencyObjective: Infertility is a common disease and accounting for 60% of female factors. Many reasons could cause oviduct obstruction, such as appendagitis, pelvic inflammation . There are many diagnoses methods, such as hydrotubation , X-ray hysterosalpingography (HSG) , laparoscopy (hysteroscopy ), and so on. Hydrotubation mainly depends on the resistance to determine , and the result is inaccurate. HSG is a commonly used method of clinical., but the patient and the doctor have to receive radiation. The oil may be noxious to the body. If the oil is not absorpted, it will produce granuloma or abdominal cavity infection. laparoscopy (hysteroscopy ) is an effective, confirmed the high rate of inspection method , but it is a invasive examination and with a certain degree of risk. This research evaluates the value of diagnosis and treatment of fallopian tube patency by using hysterosalpingocontrast sonography (HyCoSy) with SonoVue and transvaginal ultrasound for 222 infertile women.Methods: 222 infertile women were examined by HyCoSy-SonoVue to observe flowing condition in Womb and fallopian tube. Comparing the results with hydrotubation, X-ray hysterosalingography (HSG) and laparoscopy (hysteroscopy).Result: In the 222 cases, 73 cases were both side of fallopian tube patency, 72 cases were single fallopian tube patency, 13 cases were single partial obstruction, 60 cases were both side of fallopian tube pinning, 4 cases were both partial obstruction. There was a significant difference on pregnancy rates between the HyCoSy-SonoVue and hydrotubation (P<0.05). There was no difference on diagnostic rates of fallopian tube patency between the HyCoSy-SonoVue, laparoscopy (hysteroscopy) (P>0.05), the HyCoSy-SonoVue was higher rate of diagnosis than HSG .Conclusion: The HyCoSy-SonoVue method is a safety one. This method would be an effective diagnosis in the evaluation of fallopian tube pathology for infertile women.Part two Value of Contrast-enhanced Ultrasonography in Diagnosis and Differential diagnosis of HydrosalpinxObjective: Hydrosalpinx is one of commonly chronic inflammation in the fallopian tube. After salpingitis tubal atresia adhesion, mucosal cells in the secretion of fluid accumulation within the lumen, or isthmic tubal inflammation and adhesions umbrella side, blocking the formation of fallopian tube, when the lumen is absorbed within the suppurative cells , after eventually become liquid water. For a common cause of clinical abortion, spontaneous abortion, medical abortion, induced abortion, the unclean sexual intercourse, pelvic infections caused by tubal wall adhesions, hyperemia, edema and obstruction, resulting in sperm and eggs can not be combined with the ultimate form of infertility. Therefore it is vital of a clear diagnosis for the clinical further treatment. This research used two-dimensional transvaginal ultrasound and HyCoSy-SonoVue to explore value of contrast-enhanced ultrasonography in diagnosis anddifferential diagnosis of Hydrosalpinx.Methods: 28 cases of patients were examined by two-dimensional transvaginal ultrasound to observe echo-free zone of bilateral annex , to know the relative position of echo-free zone with the uterus and ovary, echo-free zone's shape, wall, internal structure, mobility, measurement and to record echo-free zone size, scope. And then to slowly inject contrast agent to intrauterine with the double-lumen catheter hysterosalpingography, in the mode of B-flow ultrasound contrast agent were observed in the uterine cavity and fallopian tubes within the developing situation.Results: 28 cases of patients (a total of 55 fallopian tubes, 1 case of tubal pregnancy due to tubal surgery to remove the side), two-dimensional transvaginal ultrasound showed that 20 cases were diagnosed as the side of hydrosalpinx, 8 cases of bilateral hydrosalpinx. Ultrasound contrast showed 3 cases were diagnosed as the side of hydrosalpinx, 2 cases of bilateral hydrosalpinx. 12 cases of the side of hydrosalpinx patients received laparoscopic surgery, postoperative results were in line with the Ultrasound contrast results. Conclusion : Two-dimensional transvaginal ultrasound combined with ultrasound contrast can increase the accuracy of diagnosis in Hydrosalpinx .It is a safe and effective method for patients and can provide an important help for clinical treatment and surgery.