The Value Of YZ-800 Contrast Agent Injection Device In Transvaginal Ultrasound Contrast Hysterosalpingography

ObjectiveTo explore the clinical value of YZ-800 contrast agent injection in transvaginal ultrasound contrast hysterosalpingography.Materials and methods1.Research object1.1 Basicresearch laboratory animals24 Healthy New Zealand rabbits,male and female,body mass is 2.0-2.5 kg.The laboratory animals were provided by the animal research center of Guangzhou general hospital,and the animal license number is SYXK(yue)2014-0100.The experiment was approved by the laboratory animal ethics committee of guangzhou general hospital.They were randomly divided into control group(n=6)and experimental group(n=18),each group is six rabbits.1.2 Clinical trialA total of 498 infertile women were evaluated for tubal patency by TVS RT-3D HyCoSy from January 2015 to February 2016,age 20-44 years old,the average age is 29.8 ±4.5.The duration of infertility 1?8 years,the average is 3.3 ± 2.7,primary infertility has 214 cases and secondary infertility has 284 cases.China association of ultrasound doctors of the inclusion criteria and exclusion criteria.Hysterosalpingo was performed at the time of in the 3 of the 7 of the ays after the period.2.Instrument and contrast agent2.1 Ultrasound instrumentGE LOGIQ E9 color doppler ultrasound diagnostic instrument,imaging probe is 9L-D,center frequency in 6-9 MHz,mechanical index 0.14.USA GE Voluson E8color doppler ultrasound diagnostic instrument,imaging probe is pressure RIC5-9-D,center frequency in the 5-9 MHz,Scanning fan angle 179 degrees,volume angle of 120 degrees,mechanical index in the 0.12~0.18.Pressure testing instrument:YZ-800 type hysterosalpingography ultrasound contrast agent injection,it has device with vibration type deck unique and real time pressure,pressure range of.0?90 kPa.2.2 Contrast agentSonoVue(Bracco company,Italian).A 59mg sulfur hexafluoride lyophilized powder mixes the 5 ml in 0.9%saline,5ml microbubble mixture and saline solution was used to make 20ml ultrasonic contrast agent when carry out the of the operation.3.Research method3.1 Experimental studyrabbits1mL/kg intravenous injection of 3%pentobarbital anesthesia and skinpreparation supine fixed ear vein indwelling needle placement in 24G for injection.The experimental conditions into the channel,the conventional ultrasound scan of rabbit liver,liver observation site and select xiphoid marker.Preparation of ultrasound contrast agent and the vibration.YZ-800 contrast agent injection and pressure device,according to the group no vibration and 60 Hz,90 Hz,120 Hz vibration gear.Start the two-dimensional gray-scale contrast button,the control group and 60 Hz,90 Hz,120 Hz sub groups respectively in 6 time periods(5,10,15,20,25,30 min)by rabbit ear with contrast agent 0.5 mg/kg,then push 1mlphysiological saline.All imaging data stored in the hard disk in order to prepare for later analysis.Intensity curve(time-intensity curve TIC)analysis software to analysis the contrast of image in the machine,the region of interest(ROI)placed in the hepatic parenchyma,area of about 0.5-1 cm2,use the gamma curve fitting method,to obtain the liver perfusion TIC.3 consecutive detection peak intensity(peak-intensity,PI),the average value of ROI in the process of sampling volume,sampling position as consistent as possible.3.2 Clinical trialsThe implementation of TVS RT 3D-HyCoSy in 498 cases of infertility women routine disinfection.we record the amount of positive contrast agent injection and return flow,the pressure of pushing and pain degree of patient.Pressure data for TVS RT 3D-HyCoSy peak pressure.After the HyCoSy completed,we recall the data of positive agent to observe the flow process of the contrast agent in the uterus and tubes pelvic.We analyse the tubal patency and the uterine cavity with the data of the uterine tubal morphology,the contrast agent wrapping around ovarian and uterine,the contrast agent diffusion pelvic,contrast agent countercurrent as well as the amount of contrast agent push and return flow,bolus comprehensive analysis to assess the degree of the pressure and pain of patients.Then analysis the peak pressure of uterine tubal,the incidence of reflux and adverse reactions,comparison of different tubal patency between the peak pressure and reflux incidence differences.4.Statistical methodsUsing SPSS 15.0 statistical software.Measurement data with the mean standard,Variance not neat,using analysis of welch compare mean differences between groups,Variance is neat,Using analysis of multiple factor of variancemeasurement data using F test.P<0.05 was statistically significant.Results1.Rabbit:Control group and 90Hz/120Hz subgroup,PI compared between groups,the difference was statistically significant(P<0.05);PI between control group and 60Hz subgroups,there was no statistically significant difference(P>0.05).PI between 60Hz subgroups and 120Hz subgroups,there was statistically significant difference(P<0.05);PI between 60Hz subgroups and 90Hz subgroups,there was no statistically significant difference(P>0.05).PI between 90Hz subgroups and 120Hz subgroups,there was statistically significant difference(P<0.05).In Control group and 90 Hz subgroup,PI comparison between for 5,10,15,20minutes,the difference between Control group with 90 Hz subgroup was no statistically significant(P>0.05).In Control group and 90 Hz subgroup,PI comparison between for 25,30 minutes,the difference between Control group with 90 Hz subgroup was statistically significant(P<0.05).2.The peak pressure of unobstructed,partially patency and fully obstr uctedwere(22.47±5.96)kPa,(37.24±8.83)kPa,(44.64±7.73)kPa.The m orphological differences between the groups were significant(P<0.01).In all 498 patients,the incidence was 26.30%.The incidence of unobstructed,partially patency and fully obstructed were 18.13%,30.21%,43.59%.No or mi Id,medium and severe adverse reactions were 88.80%,10.80%,0.40%.Conclusion1.Uusing the application of YZ-800 contrast agent injection device,it can maintain the contrast agent for 30 minutes to achieve better imaging result.2.Uusing the application of YZ-800 contrast agent injecting contrast by low pressure during TVS RT 3D-HyCoSy can reduce the incidence of reflu x and increase the comfort of patient,which is good for TVS RT 3D-HyCoSy.Using this device,the operation is simple,practical and worthy of clin ical popularization.