Study On The Diagnosis And Evaluation Of Fallopian Tube Infertility Based On Real-time Three-dimensional Contrast-enhanced Ultrasound

Objective: To evaluate the diagnosis and evaluation of tubal-derived infertility based on transvaginal real-time three-dimensional Hysterosalpingo-contrast sonography(TVSRT-3DHyCoSy).Methods: TVSRT-3DHyCoSy and three-dimensional Hysterosalpingo-contrast sonography(3D-HyCoSy)examinations were performed in the Department of Ultrasound Medicine of the Affiliated Hospital of Yan’an University from August 2016 to March 2020.One month later,they received Hysterosalpingography(HSG)examination of in the Department of Radiology,Yan’an University Hospital,All female infertility patients as the research object.using retrospective analysis method,all TVSRT-3DHyCoSy,3D-HyCoSy,and HSG examination of patients with tubal patency results were analyzed.The patient’s age,infertility year,menstrual cycle and body mass index were expressed as (?)±s.Calculate the overall compliance rate between TVSRT-3DHyCoSy,3D-HyCoSy and HSG,Kappa value,calculate the χ~2 value between TVSRT-3DHyCoSy and HSG,3D-HyCoSy and HSG(P <0.05),and Sen,Spe,PV_+,PV_,LR_+,LR__,γ values,etc.The digital evaluation scale was used to evaluate the pain of patients undergoing TVSRT-3DHyCoSy examination and the therapeutic effect on patients.The procedure followed in this study complies with the requirements of the World Medical Association Helsinki Declaration revised in 2013.Results: The average age was about 30.34 ± 4.29 years,the average infertility year was about 2.93 ± 2.22 years,the average body mass index was about 20.09 ± 2.89 kg / m~2,and the average menstrual cycle was about 30.16 ± 2.06 days.The χ~2 of TVSRT-3DHyCoSy and 3D-HyCoSy was 52.6,P <0.005,and the difference was statistically significant.The overall coincidence rate of TVSRT-3DHyCoSy and 3D-HyCoSy inspection was 85.4%(70/82),and the K value was 0.77(Z = 9.70,P <0.001),and the consistency of judgment was excellent.The χ~2 of 3D-HyCoSy and HSG was 58.9,P <0.005,the overall coincidence rate of the inspection was 73.17%(60/82),and the K value was 0.54(Z = 7.22,P <0.001).The consistency of judgment was medium and highly consistent.Using HSG as the "gold standard",the Sen,Spe,PV_+,PV__,LR_+,LR__,and γ values ??of the 3D-HyCoSy test for tubal obstruction were 73.58%,86.21%,90.70%,64.10%,5.33,0.31,and 0.60.The χ~2 of TVSRT-3DHyCoSy and HSG was 72.8,P <0.005.The overall compliance rate was 81.71%(68/82),and the K value was 0.68(Z = 10.46,P <0.001).The consistency of judgment was medium and highly consistent.Using HSG as the "gold standard",TVSRT-3DHyCoSy diagnosed fallopian tube obstruction Sen,Spe,PV_+,PV__,LR_+,LR__,and γ values ??were 86.27%,90.32%,93.62%,80.0%,8.91,0.13,0.77.The TVSRT-3DHyCoSy examination of infertility female patients with non-contrast-free,mild,moderate,and severe adverse reaction rates were 20.45%(9/44),54.54%(24/44),18.18%(8/44),and 6.82%(3/44).The overall natural conception rate of female patients with infertility tested by TVSRT-3DHyCoSy was 11.36%(5/44),the natural conception rate within 3 months was 2.27%(1/44),and ≥6 months(maximum follow-up time was 24 Month)The natural conception rate was 9.09%(4/44).Conclusion: The results of TVSRT-3DHyCoSy are better than those of 3DHyCoSy.TVSRT-3DHyCoSy is highly Spe and PV_+ for the smoothness of fallopian tubes of female infertility patients,and is worthy of clinical promotion and application.It has some value for the treatment of female infertility patients,but further research on clinical multicenter data is needed.