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中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2015, Vol. 11 ›› Issue (03): 393 -397. doi: 10.3877/cma.j.issn.1673-5250.2015.03.023

Special Issue: ；

Original Article

Contrasted research of iodized oil and nonionic iodinated contrast media in hysterosalpingography

Changyv Zhang1, Wanjing Bai2(), Gang Ning2, Kaiming Li2, Fumin Zhao2, Xuesheng Li2   

  1. 1. Department of General Surgery, People's Hospital of Deyang, Deyang 618000, Sichuan Province, China
    2. Department of Radiology, West China Second University Hospital, Chengdu 610041, Sichuan Province, China
  • Received:2015-02-03 Revised:2015-03-20 Published:2015-06-01
  • Corresponding author: Wanjing Bai
  • About author:
    Corresponding author: Bai Wanjing, Email:
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Objective

To discuss the image quality and adverse effects among different kinds of iodinated contrast media in hysterosalpingography (HSG).

Methods

From May 2003 to November 2011, a total of 99 female infertile patients were included in the study.They were divided into three groups according to different iodinated contrast media in HSG, group A(n=33, 40% iodized oil), group B(n=33, iopamidol injection) and group C(n=33, iohexol injection). The HSG image quality and adverse effects were recorded. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Second University Hospital.Informed consent was obtained from each participants.

Results

①HSG results of 22 cases(22.2%)showed intrauterine adhesion, 53 cases(53.5%)showed infertility.②The scores of HSG image quality was (2.5±0.5) score in group A, (2.4±0.5) score in group B, (2.2±0.4) score in group C, and the differences were significant among three groups(H=6.680, P=0.034). ③There were significant differences among three goups in adverse effects(χ2=7.155, P=0.028).

Conclusions

Three kinds of iodinated contrast media can all be applied in HSG. For nonionic iodinated contrast media, the higher of iodinated concentration, the better of image contrast, which makes image quality much better. For 40%iodized oil, the image quality was the best but the adverse effects were obvious.

Key words: Hysterosalpingography, Contrast media, Image quality, Adverse effects
表1 HSG图像质量评分标准
Table 1 Standard of image score
评分(分) 图像层次显示程度，造影区域和非造影区域的对比度 宫腔内充盈缺损的显示程度 峡部的显示程度 少量弥散影的显示程度 伪影
3 宫腔或输卵管显影浓，边界光滑、连续，与非造影区域对比明显 清晰可见，边界清楚 清晰可见 可见 无
2 宫腔或输卵管显影较淡，边界较毛糙，与非造影区域对比稍差 可见，边界较清楚 可见 隐约可见 有
1 宫腔或输卵管显影很淡，边界不清，与非造影区域对比差 不可见，边界不清 不可见 不可见 严重
表2 3组患者HSG结果[例数(%)]
Table 2 Results of HSG in three groups [case(%)]
组别 例数 宫腔黏连 子宫发育畸形 输卵管病变 正常
单侧 双侧
A组 33 7(21.2) 2(6.1) 5(15.1) 12(36.4) 7(21.2)
B组 33 13(39.4) 0(0.0) 7(21.2) 9(27.3) 4(12.1)
C组 33 2 (6.1) 0(0.0) 12(36.4) 8(24.2) 11(33.3)
合计 99 22(22.2) 2(2.0) 53(53.5) 22(22.2) ?
图1 A组宫腔充盈缺损、输卵管病变的HSG图像
Figure 1 HSG findings of filling defect and tubal disease in group A
图2 B组宫腔充盈缺损、输卵管病变的HSG图像
Figure 2 HSG findings of filling defect and tubal disease in group B
图3 C组宫腔充盈缺损、输卵管病变的HSG图像
Figure 3 HDG findings of filling defect and disease in group C
表3 3组患者不良反应比较[例数(%)]
Table 3 Comparison of adverse effects among three groups[case(%)]
组别 例数 不良反应发生率 腹痛 迷走神经亢进
有 无 有 无
A组 33 9(27.27) 6(18.18) 27(81.82) 3(9.09) 30(90.91)
B组 33 3 (9.09) 2 (6.06) 31(93.94) 1(3.03) 32(96.97)
C组 33 2 (6.06) 1 (3.03) 32(96.97) 1(3.03) 32(96.97)
χ2值 ? 7.155 － －
P值 ? 0.028 － －
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