Objective To investigate the diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography(4D-HyCoSy)in assessing tubal patency in patients with infertility.Methods A total of 160 patients with infertility diagnosed at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Zhejiang Chinese Medical University,from June 2019 to June 2022 were retrospectively included in this study.All patients underwent 4D-HyCoSy examinations.The results of hydrotubation were used as the gold standard to evaluate the diagnostic efficacy of 4D-HyCoSy for assessing tubal patency in patients with infertility.The differences in the pelvic dispersion of the contrast agent and the surrounding conditions of the ovaries were evaluated across varying degrees of tubal patency.Any adverse reactions experienced by patients during the 4D-HyCoSy examination were recorded.Results The diagnostic agreement rates of 4D-HyCoSy for assessing tubal patency,partial patency,and obstruction in patients with infertility were 90.07％(127/141),92.10％(105/114),and 93.85％(61/65),respectively.The sensitivity,specificity,and accuracy of 4D-HyCoSy examination for diagnosing tubal patency in patients with infertility were 93.85％(61/65),99.22％(253/255),and 98.12％(314/320),respectively.Statistically significant differences were observed in the pelvic dispersion of the contrast agent and the surrounding conditions of the ovaries across varying degrees of tubal patency(x2=411.58,286.32,both P＜0.001).The incidence of mild pain during the 4D-HyCoSy examination was 18.12％(29/160),with no other adverse reactions reported.Conclusion 4D-HyCoSy has a low incidence of adverse reactions and high safety.Its diagnostic results show a high level of consistency with hydrotubation results,making it an effective method for assessing and diagnosing tubal patency in patients with infertility.
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