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中华医学超声杂志(电子版) ›› 2020, Vol. 17 ›› Issue (02) : 108 -114. doi: 10.3877/cma.j.issn.1672-6448.2020.02.004

所属专题: 总编推荐 妇产科超声影像学 文献 指南共识

专家共识

不孕症"一站式"子宫输卵管超声造影技术专家共识
不孕症"一站式"超声检查体系多中心研究专家团队   
  • 收稿日期:2019-09-09 出版日期:2020-02-22

Expert consensus on "one-stop" hysterosalpingography for infertility in women

the Team of Multi-Center Clinical Research Study of “One-Stop” Sonography System for Female Infertility   

  • Received:2019-09-09 Published:2020-02-22
引用本文:

不孕症"一站式"超声检查体系多中心研究专家团队. 不孕症"一站式"子宫输卵管超声造影技术专家共识[J]. 中华医学超声杂志(电子版), 2020, 17(02): 108-114.

the Team of Multi-Center Clinical Research Study of “One-Stop” Sonography System for Female Infertility. Expert consensus on "one-stop" hysterosalpingography for infertility in women[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(02): 108-114.

图1 子宫输卵管造影通水管图像。图a为单侧开孔子宫输卵管造影通水管,造影管头端单侧开孔(实心箭头),造影剂从单侧开孔处喷出,且开孔处至造影管顶端(空心箭头)距离较长;图b为双侧开孔子宫输卵管造影通水管,造影管头端双侧开孔(实心箭头),造影剂从双侧开孔处喷出,且开孔处至造影管顶端(空心箭头)距离较短
图2 不孕症"一站式"子宫输卵管超声造影技术操作流程图
图3 子宫三维超声图像。图a为子宫三维超声成像显示完全纵隔子宫(箭头所示),其需在后续的造影中置入2根造影管或左右两侧分开造影;图b为子宫三维超声成像显示造影管位置过高(箭头所示),抵住左侧宫角部,需要调整造影管位置
图4 子宫输卵管造影通水管置入位置及水囊大小的超声图像。图a为三维超声成像示造影管位置过高,头端抵住左侧宫角处(箭头所示);图b为二维超声示造影管位置过低,水囊位于宫颈管内(箭头所示);图c、d为二维超声示造影管位置适中,水囊下缘位于宫颈内口水平(图c为宫腔水造影环节的水囊大小,注入液体量为0.5~1.0 ml;图d为输卵管超声造影环节的水囊大小,注入液体量为1~3 ml)
图5 子宫内膜病变的常规二维超声与宫腔水造影图像。图a为常规二维超声显示子宫内膜未见明显占位性病变;图b为同一病例宫腔水造影显示子宫内膜息肉
图6 输卵管超声造影图像。图a为低机械指数三维超声造影(含实时三维和静态三维),显示造影剂在宫腔、输卵管、盆腔内的立体运行轨迹;图b为低机械指数二维超声造影与二维灰阶超声同屏对照,实时观察造影剂的卵巢周围包绕和盆腔弥散情况;图c为高机械指数二维超声造影,在造影的同时保留盆腔解剖结构的二维灰阶图像,以便观察造影剂与解剖结构之间的关系
图7 盆腔水造影二维超声图像。图示在盆腔内无回声的液体(0.9%的氯化钠溶液)背景下,可清晰显示输卵管伞端的指状突起(箭头所示)
图8 经阴道与经腹部途径超声造影对输卵管的显影效果。图a示平位子宫,经阴道途径超声造影难以显示宫角和输卵管;图b示改为经腹部途径超声造影,可清楚显示输卵管的走行
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