Purpose

To analyze the clinical value of transvaginal hysterosalpingography (TVS4D-HyCoSy) combined with transvaginal hysterosalpingography (TVS2D-HyCoSy) in assessing tubal patency in infertile patients.

Method

Ninety-nine infertile patients who visited Sijing Hospital, Songjiang District, Shanghai from March 2020 to March 2022 were selected as the study subjects. All patients received TVS4D-HyCoSy and TVS4D-HyCoSy examinations. The consistency analysis was performed using laparoscopic methylene blue staining under direct vision as the gold standard. The diagnostic value of the two alone and in combination was compared. The diagnostic efficacy of TVS4D-HyCoSy, TVS2D-HyCoSy examinations and the combination of the two modalities in the diagnosis of tubal patency was evaluated and analyzed. The shape, thickness, length and development of the fallopian tube were dynamically observed and recorded, respectively.

Results

A total of 194 fallopian tubes (4 unilateral salpingectomy for ectopic pregnancy) in 99 patients with infertility were examined by laparoscopic methylene blue drainage. 106 fallopian tubes were patent, 48 fallopian tubes were poor, and 40 fallopian tubes were obstructed. Kappa analysis showed that the agreement between TVS4D-HyCoSy and TVS2D-HyCoSy alone and laparoscopic direct vision methylene blue liquid examination was fair, and the agreement between the combination of the two and laparoscopic direct vision methylene blue liquid examination was good, and superior to the two alone diagnosis (P < 0.05); the diagnostic sensitivity of TVS4D-HyCoSy combined with TVS2D-HyCoSy was 90.90% (80/88) higher than that of the two alone 79.54% (70/88) and 60.23% (53/88), and the diagnostic accuracy 82.99% (161/194) was higher than that of the two alone 77.34% (150/194) and 68.55% (133/194), and the difference was statistically significant (P < 0.01); the specificity of the combination of the two was 76.41% (81/106) compared with 75.47% (80/106) and 75.47% (80/106), respectively, and the difference was not statistically significant (P > 0.05)

Conclusion

This study shows that the combined diagnosis of the two modal transvaginal contrast-enhanced ultrasound techniques has higher sensitivity, specificity and accuracy for tubal patency in infertile patients than the two alone, which can guide clinical diagnosis and treatment and has important clinical value.