OC24.04: Study on correlation between tubal patency and uterine pressure under three‐dimensional hysterosalpingo‐contrast‐sonography

Abstract

This study focus on the relationship between patency and morphology of the fallopian tube and the dynamic changes of intrauterine pressure to explore the semi-quantitative grading of tubal patency. 125 fallopian tubes of 67 patients, including 2 single-horned uterus and 7 unilateral fallopian tubes because of a unilateral salpingectomy for an ectopic pregnancy were studied, exclude at least one side of patients with tubal obstruction. According to the patency classification standard of fallopian tubes, they were divided into patency group (the fallopian tube has a natural shape, uniform and aspillage from the fimbrial end of the tubes, 103 tubes) partial patency (the fallopian tube is twisted, the ampulla is bulging, the thickness is uneven and the a spillage from the fimbrial end is slow, 22 tubes). There was a significant difference between the development pressure of the fallopian tube and the peak pressure of the uterine cavity in the patency group and the partial patency group (P < 0.01). According to the ROC curve, the best cutoff value of partial patency fallopian tube development pressure is 18Kpa, the sensitivity is 71.43%, and the specificity is 81.73%. In the partial tubal, the tubal development pressure is low but the shape is distorted and reflexed, this is adhesion around the fallopian tube because of chronic pelvic inflammatory disease and other diseases, the fallopian tube is actually patency. While subtracting the case which the development pressure is lower than 18Kpa, the pressure value of the best cutoff value for the patency tubal is 18Kpa (the sensitivity is 93.75% and the specificity is 82.57%). 3D HyCoSy combined with uterine pressure can more clearly show the patency of the fallopian tube, which can further improve the diagnostic accuracy. Pressure quantification combined with the shape of the fallopian tube contribute to the specific grading of tubal patency.