Application Of Contrast-enhanced Ultrasonography In Fallopian Tube Infertility:a Preliminary Study

PartⅠ: A preliminary study of SonoVue-hysterosalpingo-contrastsonography in Diagnosis tubal patencyObjective: Observing the performance of different tubal patency in SonoVue-hysterosalpingo-contrast sonography, to provide a new screening method to fallopiantube infertility.Methods:56patients with105tubes at the First Affiliated Hospital of XXXMedical College from May2010to Dec.2010, were performed examination ofContrast-enhanced Ultrasound before surgical operation, using the Philips companyiU22Ultrasound diagnostic apparatus and the Bracco company ultrasound contrastagent SonoVue. Two senior physicians from the first two-dimensional ultrasound andDoppler ultrasound examination, then underwent SonoVue-HyCoSy to observe thecontrast agent within the flow process in the fallopian tubes to determine tubalpatency.Used SPSS17.0for statistical analysis, p<0.05was considered to be statisticallysignificant.Results:56patients, the median age of28years of infertility; median time of2years ofinfertility. Secondary infertility (59tube) through which the incidence of partialobstruction and obstruction ratio of59.3%(35/59), primary infertility (46tube) throughthe poor and the composition ratio of the incidence of obstruction26.1%(12/46), tubaldisease occurred between the two statistically significant difference (P <0.01).In the105tubes,58tubes were patency,26tubes were partial obstruction,21tubes were blocked.Conclusion: The patients in the lesions of secondary tubal infertility were significantlymore than primary infertility; SonoVue-HyCoSy patency of the fallopian tube for adifferent characteristic performance, can be used for preliminary evaluation of tubalpatency. Part Ⅱ: The clinical value of Contrast-enhanced Ultrasonography inFallopian tube InfertilityObjective: To investigate the efficiency and application value of SonoVue-hysterosalpingo-contrast sonography compare with hysterosalpingography andlaparoscopy， in differential tubal patency.Methods: Patient information and SonoVue-HyCoSy methods were same as the firstpart. The day after the ultrasound, the infertility patients randomized43patients withfallopian tube for83hysterosalpingography，13Example22tubes laparoscopy.examination. Comparative results of SonoVue-HyCoSy diagnostic efficiency. UsedSPSS17.0for statistical analysis, p<0.05was considered to be statistically significant.Results: Compared with hysterosalpingography, tubal patency, and partial obstruction,blocking and total compliance rate was94.5%,64.0%,90.3%,89.2%. Two methods arehighly consistent. Results as the gold standard of laparoscopy diagnosis of tubal patencycontrast sensitivity, specificity, positive predictive value, negative predictive value andaccuracy were100%,71%,94%,100%,95.5%. The Kappa agreement test, Kappa=0.8129(p=0.000), p <0.05, and laparoscopic ultrasound has a high degree ofconsistency.Conclusion: SonoVue-HyCoSy in the diagnosis of tubal origin infertility have highsensitivity and specificity, compared to HSG and LPS, no radiation damage,non-invasive, with potential clinical application.