Research On Contrast Agent Reflux During Transvaginal Real-time Three-dimensional Hysterosalpingo-contrast Sonography

ObjectiveThe objective of this study is to evaluate the clinical value of patency assessment of the fallopian tube in female patients with infertility when contrast agent reflux during transvaginal real time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D HyCoSy).MethodsDate from533infertile women treated with TVS RT-3D HyCoSy between July2012and October2013were retrieved. The GE voluson E8ultrasonic diagnostic apparatus from US and the Bracco SonoVue ultrasonic contrast agent from Italy were used in procedure. Other adjusted modality:RIC5-9-D angiography probe, the center frequency5.0～9.0MHZ, Mechanical index:0.12～0.18, scanning fan angle179°, volume angle120°. Two experienced doctors cooperated with each other during examination, focusing on observing contrast agent reflux. Then the incidence rate and injection pressure results were compared with the patency. Multivariate logistic regression was performed to identify significant risk factors associated with contrast agent reflux. SPSS13.0statistical software was used for statistical analysis. And it’s considered significant when P<0.05.ResultsOf the533cases included in this study, contrast agent reflux were observed in199patients. The incidence is37.34%; bilateral patency with nonbilateral patency, the incidence of reflux and the risk of refux difference were statistically significant (P<0.05);309cases of consistent bilateral tubal patency show that the differences of injection pressure between patients with no contrast agent and with contrast agent reflux in myometrium were not statistically significant. The differences of injection pressure between patients with no contrast agent and with venous reflux were statistically significant (P<0.05), when bilateral passable and bilateral barrier. Mutivariate analysis indicated that a history of pregnancy, tubal patency were significantly associated with contrast agent reflux. The risk of reflux in secondary infertility was2.10times to idiopathic infertility (P<0.001)ConclusionThe TVS RT-3D HyCoSy can clearly show the location of countercurrent which occurs with the type of infertility and tubal patency. Venous reflux will effect the clinic reference value during assessment of tubal patency by injection pressure.