Objective To examine the diagnostic value of delayed radiographs taken at 2 h and 6 h after performing ethiodized poppyseed oil hysterosalpingography (HSG) to assess tubal patency and pelvic adhesion. Methods A total of 86 female infertility patients, with an average age of 30.30 ± 4.59 years, an average duration of infertility of 2.12 ± 2.45 years, an average number of pregnancies of 1.26±1.50, and an average number of deliveries of 0.43±0.56, were chosen from those who underwent HSG with ethiodized poppyseed oil at Xuzhou Central Hospital from August 2022 to August 2023. Out of the patients in the study, 14 had a history of pelvic inflammatory diseases, 6 had a history of endometrial conditions, 9 had a history of appendicitis, 19 had a history of tubal pregnancy, 11 had a history of caesarean delivery, and 17 had a history of other pelvic surgery. The patients were directed to walk a distance of at least 6000 steps within a time frame of 6 h following the HSG operation. The diagnostic consistency of tubal patency and pelvic adhesion was assessed by calculating Cohen's Kappa coefficient for the delayed radiographs taken at 2 h, 6 h, and 24 h. A confusion matrix was generated to analyze the diagnostic findings of the 2 h and 6 h delayed radiographs compared to the 24 h delayed radiographs. The key evaluation metric utilized was the area under the curve (AUC), combined with accuracy, precision, sensitivity, specificity, and the F1-score, to assess the diagnostic value of delayed radiographs taken at 2 h and 6 h. Results The delayed radiographs taken at 2 h and 24 h intervals indicated a moderate level of consistency (Kappa=0.599, P<0.001) and a moderate capacity to diagnose tubal patency (AUC=0.836). The evaluations conducted at 6 h and 24 h intervals demonstrated a high level of consistency (Kappa=0.934, P<0.001) and excellent diagnostic capacity (AUC=0.979). In the case of pelvic adhesion, the intervals of 2 h and 24 h showed a low level of consistency (Kappa=0.374, P<0.001) and a lower ability to diagnose (AUC=0.670). On the other hand, the intervals of 6 h and 24 h demonstrated a high level of consistency (Kappa=0.780, P<0.001) and moderate diagnostic efficacy (AUC=0.870).Conclusion Patients who exceed 6000 steps within 6 h after receiving ethiodized poppyseed oil HSG can use the 6 h delayed radiographs instead of the 24 h delayed radiographs for diagnosing tubal patency and pelvic adhesion severity. However, the delayed radiographs taken at 2 h cannot adequately replace the delayed radiographs taken at 24 h in terms of diagnosing a condition.
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