Diagnostic Value of Multimodal Transvaginal Contrast-Enhanced Ultrasound Combined with Negative Intrauterine Contrast-Enhanced Ultrasound in Female Infertility

Abstract BACKGROUND: Given the important role of the fallopian tube and uterine cavity in human reproduction, a simple, accurate, and quick method for determining fallopian tube patency and diagnosing uterine cavity lesions is needed. This study aimed to investigate the diagnostic value of multimodal transvaginal contrast-enhanced ultrasound combined with negative intrauterine contrast-enhanced ultrasound for infertility in women.METHODS: A total of 310 patients with infertility were treated in the outpatient clinic of the Union Hospital of Fujian Medical University, from November 2017 to October 2020. Multimodal contrast-enhanced ultrasound combined with negative contrast-enhanced uterine cavity examination was used to analyze transvaginal four-dimensional contrast-enhanced hysterosalpinx ultrasound (TVS 4D-HyCoSy, 4D), three-dimensional hysterosalpinx contrast ultrasound (TVS 3D HyCoCoCoSyGray 3D), two-dimensional hysterosalpinx contrast-enhanced ultrasonography (TVS, 2D), and transvaginal harmonic imaging (TVS, HI), and other modal techniques were used to compare tubal patency diagnostic efficiency between a high- and a low seniority group. Further, the diagnostic efficiency of negative hysterography was analyzed in uterine lesions.RESULTS: Among the 310 infertile patients, four gave up examination due to pain. In the other 306 patients, salpingography was successful in 612 cases, revealing 538 patency cases and 74 obstruction cases. In both high- and low seniority groups, tubal patency diagnosis efficiency was significantly different (P<0.01), with the combination of different modes. Similarly, the differences between the following groups were also statistically significant (P<0.05): 4D+3D+2D+HI and 4D+3D+2D, 4D+3D+2D and 4D+3D, and 4D+3D and 4D. However, there was no significant difference in the diagnostic efficiency of fallopian tube patency examination under various multi-modes between the high- and low seniority groups (P>0.05). A total of 306 patients underwent successful negative intrauterine contrast examination. Its accuracy was 91.94% (57/62).CONCLUSIONS: Multimodal transvaginal contrast-enhanced ultrasound combined with negative intrauterine contrast-enhanced ultrasound has high accuracy and consistency in fallopian tube patency and uterine lesions evaluation; thus, it is worth promoting.