Clinical value of uterine cavity pressure measurement in assisting with four-dimensional hysterosalpingo-contrast sonography in assessing tubal patency
Objective Explore the auxiliary role and clinical value of uterine cavity pressure measurement in assessing tubal patency in four-dimensional hysterosalpingo-contrast sonography(4D-HyCoSy).Methods 132 suspected tubal infertility patients treated at The Central Hospital of Yongzhou from February 2019 to September 2022 were selected as the research objects.All patients underwent 4D-HyCoSy examination.The diagnostic results of 4D-HyCoSy were compared with those of laparoscopic fluid test,taken as the gold standard.The application value of uterine cavity pressure measurement in assisting 4D-HyCoSy examination in diagnosing tubal patency was analyzed using receiver operating characteristic(ROC)curve and logistic regression model.Results Among the 132 patients who completed 4D-HyCoSy examination,out of 264 fallopian tubes,145 were patent(54.92％),77 were patent with partial blockage(29.17％),and 42 were completely blocked(15.91％).Results of laparoscopic fluid test showed 132 tubes were patent(50.00％),77 were patent with partial blockage(29.17％),and 55 were completely blocked(20.83％).Taking laparoscopic fluid test results as the gold standard,in 4D-HyCoSy examination,216 tubes matched the results of laparoscopic fluid test,with a diagnostic accuracy rate of 81.82％(216/264).The highest diagnostic consistency rate was found for tubes diagnosed as patent,at 93.18％(123/132).Stratified evaluation based on tubal function showed a diagnostic accuracy rate of 86.36％(114/132)between 4D-HyCoSy examination and laparoscopic fluid test.There were statistically significant differences in uterine cavity pressure peak values among the bilateral patent(Group A),incomplete patent(Group B),and bilateral blocked(Group C)tubes(F=39.334,P＜0.001).The differences in uterine cavity pressure peak values between Group A and Group B,Group A and Group C,and Group B and Group C were all statistically significant(t=28.178,66.049,and 30.774,respectively,P＜0.001),with increasing severity of blockage associated with higher uterine cavity pressure peak values.ROC curve analysis showed that the area under the curve(AUC)of the predictive model for assessing tubal patency using uterine cavity pressure measurement as an adjunct to 4D-HyCoSy was 0.853,with a sensitivity of 88.13％and specificity of 79.46％,significantly higher than the single diagnostic result of 4D-HyCoSy.Conclusion Uterine pressure measurement assisted 4D-HyCoSy can significantly improve the diagnostic efficiency of tubal patency and serve as an effective diagnostic method for clinical assessment of tubal patency,with potential for clinical application.
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维普
