罗 茜,熊正方

随着超声技术和造影剂的发展，子宫输卵管超声检查经历二维、三维阶段的发展已经成为目前使用最多的经阴道四维子宫输卵管超声造影（transvaginal ultrasound four dimensional hysterosalpingography contrast sonography,TVS-4D-HyCoSy）。TVS-4D-HyCoSy在临床中广泛的用于检查输卵管的通畅性，因其准确价值高、较其他诊断输卵管通畅的方法有一定的优势而得到不孕女性的青睐。然而，当前对TVS-4D-HyCoSy在诊断输卵管梗阻或双侧输卵管通畅程度不同时、助孕作用、减轻不良反应的措施等方面意见尚不统一。综述TVS-4D-HyCoSy的发展历程、在不孕症女性中的有效价值、不良反应的处理措施以及未来展望。

不孕症；经阴道四维子宫输卵管超声造影；有效性；不良反应

[1] 彭丹妮,符元春,邝海燕,等.四维宫腔输卵管超声造影联合宫腔压力测量对输卵管通畅性的评价效果分析[J].影像科学与光化学, 2020,38(06):977-981. [2] Campbell S,Bourne T H,Tan S L,et al.Hysterosalpingo contrast sonography(HyCoSy)and its future role within the investigation of infertility in Europe[J].Ultrasound Obstet Gynecol,1994,4(3):245-253. [3] 王莎莎.子宫输卵管超声造影临床应用与进展[J].中华医学超声杂志(电子版),2020,17(02):100-102. [4] Gao Y B,Yan J H,Yang Y D,et al.Diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography combined with recanalization in patients with tubal infertility[J].Niger J Clin Pract,2019,22(1):46-50. [5] Wang W.EP35.07:Analysis of tubal occlusion region proportion in four‐dimensional hysterosalpingo‐contrast‐sonography[J]. Ultrasound in Obstetrics&Gynecology,2019,54(S1):453. [6] 萧利霞.经阴道子宫输卵管四维超声造影检查在不孕症诊断中的应用价值分析[J].影像研究与医学应用,2022,6(13):167-169. [7] 薛海英,李舍,吕亚南.四维子宫输卵管超声造影对输卵管阻塞性病变诊断效能及不良反应[J].中国计划生育学杂志, 2021,29(04):811-814. [8] 古梅,陈红坚,宁荣萍,等.经阴道子宫输卵管四维超声造影联合盆腔水灌注显示输卵管伞端[J].中国医学影像技术, 2021,37(11):1694-1697. [9] Bisogni F A,Galanti F,Riccio S,et al.4D-HyCoSy performed in a reproductive center:retrospective analysis of pain perception, complications and spontaneous pregnancy rate after the technique[J].Eur Rev Med Pharmacol Sci,2021,25(23):7468-7475. [10] 杜晓果,王艳华,勾雪梅,等.四维子宫输卵管超声造影输卵管通畅度及术后妊娠结局相关影响因素分析[J].生殖医学杂志, 2022,31(06):725-732. [11] Lindborg L,Thorburn J,Bergh C,et al.Influence of HyCoSy on spontaneous pregnancy:a randomized controlled trial[J].Hum Reprod, 2009,24(5):1075-1079. [12] Bisogni F,Galanti F,Riccio S,et al.Spontaneous Pregnancy after 4D-Hysterosalpingo-Sonography(HyCoSy)in the Same Menstrual Cycle:A Case Report and an Updating Review of the Current Literature regarding the Positive Impact of Tubal Flushing Effect on Fertility[J].Case Rep Obstet Gynecol,2024,2024:7774854. [13] Hu H,Kirby A,Dowthwaite S,et al.Lipiodol flushing under ultrasound guidance at time of hystero-salpingo contrast sonography (HyCoSy):A retrospective observational study[J].Aust N Z J Obstet Gynaecol,2022,62(5):755-760. [14] Pei R,Tang M.Comparison of Effectiveness as well as Advantages and Disadvantages of Different Dimensions of Hysterosalpingo- Contrast Sonography for Diagnosis of Lesions Associated with Female Infertility[J].Computational and mathematical methods in medicine, 2022,2022:7508880-7508887. [15] 刘雨,葛丹,姚洁,等.四维输卵管超声造影评价子宫内膜病变对输卵管阻塞的风险预测[J].现代实用医学,2024,36(03):335-337. [16] Alcazar J L,Martinez A,Duarte M,et al.Two-dimensional hysterosalpingo-contrast-sonography compared to three/four-dimensional hysterosalpingo-contrast-sonography for the assessment of tubal occlusion in women with infertility/subfertility:a systematic review with meta-analysis[J].Hum Fertil(Camb),2022,25(1):43-55. [17] 朱桂清,李慧斌,巫伟芳.三维和四维子宫输卵管超声造影在输卵管通畅性评估中的对比研究[J].实用医技杂志, 2018,25(12):1345-1347. [18] 向小珍,胡兵,陈思晗,等.对比四维子宫输卵管超声造影与子宫输卵管造影评估输卵管通畅性效能:Meta分析[J].中国介入影像与治疗学,2022,19(04):215-220. [19] Maxim A R,Gligor O H,Badea R I.Comparison of Hystero-salpingography and Hysterosalpingo-Contrast Sonography for tubal patency testing:technical success,pain perception,side effects and complications[J].Med Ultrason,2021,23(3):283-288. [20] 张向卉,王新花,王雁林,等.经阴道子宫输卵管四维超声造影常见问题及对策[J].滨州医学院学报,2021,44(06):455-458. [21] Boned-Lopez J,Alcazar J L,Errasti T,et al.Severe pain during hysterosalpingo-contrast sonography(HyCoSy):a systematic review and meta-analysis[J].Arch Gynecol Obstet,2021,304(6):1389-1398. [22] Zhang N,Liu Y,He Y,et al.Transvaginal four-dimensional hysterosalpingo-contrast sonography:Pain perception and factors influencing pain severity[J].J Obstet Gynaecol Res,2021,47(1):302-310. [23] Ma Y,Du L,Li F,et al.Use of atropine in four-dimensional hysterosalpingo-contrast sonography:Does it suppress pain during infertility examination?[J].Clin Exp Pharmacol Physiol,2018,45(12):1334-1340. [24] Jayeola D K,Bello T O,Oyedepo V O,et al.The efficacy of oral naproxen and cervical lidocaine spray on perceived pain during hysterosalpingography[J].Niger Postgrad Med J,2021,28(3):193-197. [25] 谢惠玲.穴位贴敷联合热敷对子宫输卵管超声造影患者不良反应的干预效果[D].南方医科大学,2023. [26] Rodgers R,Ludlow J,Gee A,et al.Clinical case presentation:life threatening Group A sepsis secondary to HyCoSy[J].Australas J Ultrasound Med,2014,17(3):131-133. [27] Sun X,Cai J,Yu H,et al.Revolutionizing Fallopian Tube Evaluation in Infertility:Transvaginal Sonography Case Study[J].Int J Womens Health, 2023,15:1895-1899.

点击下载PDF