对比四维子宫输卵管超声造影与子宫输卵管造影评估输卵管通畅性效能:Meta分析

目的 采用Meta分析对比四维子宫输卵管超声造影（4D-HyCoSy）与子宫输卵管造影（HSG）评估输卵管通畅性的效能。方法 系统搜索PubMed、Cochrane Library、Embase、Web of Science、中国生物医学文献数据库、中国知网、万方医学网及维普数据库中建库至今有关4D-HyCoSy和/或HSG评估输卵管通畅性的文献。由2名研究人员依据纳入标准和排除标准筛选文献并提取信息；分别计算4D-HyCoSy和HSG评估输卵管通畅性的合并敏感度（SEN）、特异度（SPE）及诊断比值比（DOR），绘制综合受试者工作特征（SROC）曲线，获得曲线下面积（AUC），并以Medcalc 19.1.1统计软件比较AUC。结果 最终纳入19篇文献、1 358例疑似输卵管因素导致不孕患者，其中4篇同时采用4D-HyCoSy及HSG评估输卵管通畅性，10篇仅以4D-HyCoSy评估，5篇仅以HSG评估。Meta分析结果显示，4D-HyCoSy评估输卵管通畅性的合并SEN、SPE及DOR分别为0.9295%CI（0.91，0.94）]、0.9195%CI（0.89，0.93）]及115.0695%CI（54.23，224.10）]；HSG评估输卵管通畅性的合并SEN、SPE及DOR分别为0.8495%CI（0.81，0.87）]、0.8095%CI（0.76，0.83）]及28.6495%CI（10.08，81.35）]。4D-HyCoSy评估输卵管通畅性的AUC为0.9895%CI（0.96，0.99）]，HSG为0.9395%CI（0.90，0.95）]，差异有统计学意义（Z=6.97，P<0.01）。结论 4D-HyCoSy评估输卵管通畅性的效能高于HSG。

Comparsion on efficacy of four-dimensional hysterosalpingo-contrast sonography and hysterosalpingography for evaluation on tubal patency: Meta-analysis

Objective To compare the efficacy of four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) and hysterosalpingography (HSG) for evaluation of tubal patency with meta analysis. Methods PubMed, Cochrane Library, Embase, Web of Science and CBM, CNKI, Wanfang Med Online and VIP database were searched for relevant literature on diagnosis of tubal patency with 4D-HyCoSy and/or HSG from the establishment to the present. Two researchers screened literature according to inclusion and exclusion criterias and extracted information. Combined sensitivity (SEN), specificity (SPE) and diagnostic odds ratio (DOR) were calculated for evaluation of tubal patency with 4D-HyCoSy and HSG, respectively. A summary receiver operating characteristic (SROC) curve was drawn to obtain the area under the curve (AUC), and the AUC were compared with Medcalc 19.1.1 software. Results A total of 19 articles were enrolled, including 1 358 cases of infertility caused by suspected tubal factors. There were 4 articles evaluated tubal patency with both 4D-HyCoSy and HSG, 10 with 4D-HyCoSy alone and 5 with HSG alone. The results of meta-analysis showed that the combined SEN, SPE and DOR of 4D-HyCoSy diagnosis of tubal patency was 0.92 (95%CI 0.91, 0.94]), 0.91 (95%CI 0.89, 0.93]) and 115.06 (95%CI 54.23, 224.10]), of HSG was 0.84 (95%CI 0.81, 0.87]), 0.80 (95%CI 0.76, 0.83]) and 28.64 (95%CI 10.08, 81.35]), respectively. The AUC of SROC curve for evaluation of oviduct patency with 4D-HyCoSy was 0.98 (95%CI 0.96, 0.99]), of HSG was 0.93 (95%CI 0.90, 0.95]), and difference was statistically significant (Z=6.97, P<0.01). Conclusion 4D-HyCoSy was more effective than HSG for evaluating tubal patency.