Comparison of Effectiveness as well as Advantages and Disadvantages of Different Dimensions of Hysterosalpingo-Contrast Sonography for Diagnosis of Lesions Associated with Female Infertility

Abstract

Background and Objective. With social pressures and changes in lifestyle habits, the incidence of female infertility has increased in recent years. How to make timely and accurate assessment of the patency of the fallopian tubes in infertile women is of great importance in the clinical management of infertility. Therefore, this study aims to provide a reference for the future clinical application of hysterosalpingo-contrast sonography (HyCoSy) by comparing the advantages and disadvantages of different dimensions of HyCoSy for the diagnosis of female infertility. Methods. Forty subjects who underwent routine two-dimensional (2D) vaginal ultrasound, three-dimensional HyCoSy (3D-HyCoSy), and four-dimensional HyCoSy (4D-HyCoSy) examinations from January 2021 to July 2022 at the ultrasound department of Pukou Branch of Jiangsu Province Hospital were enrolled to this study. Fallopian tubal recanalization by hydrotubation (FTRH) was used as the gold standard to compare the efficacy of 2D vaginal ultrasound, 3D-HyCoSy, and 4D-HyCoSy in assessing the subjects for the presence of polyps, myomas, and other occupants in the uterine cavity or uterine adhesions. Results. A total of 18 cases of uterine cavity lesions, 11 of pelvic lesions, and 11 of ovarian lesions were identified by FTRH, while 80 fallopian tubes were found in 40 patients and 71 tubal obstructions were detected by FTRH. Vaginal ultrasound assessment of uterine cavity, pelvis, ovarian lesions, and tubal obstruction was moderately consistent with FTRH ( $\text{Kappa}=0.616$ , 0.673, 0.654, and 0.640), 3D-HyCoSy was in good agreement with FTRH ( $\text{Kappa}=0.812$ , 0.910, 0.906, and 0.894), and 4D-HyCoSy was in good agreement with FTRH ( $\text{Kappa}=0.914$ , 0.903, 1.000, and 0.942), with 4D-HyCoSy being in good agreement with FTRH had the highest agreement. Conclusion. 4D-HyCoSy can be used as an effective tool for clinical diagnosis of female tubal obstruction infertility and provide a reference basis for the design of subsequent clinical treatment plans.