实用临床医药杂志2025，Vol.29Issue(23)：42-47,6.DOI:10.7619/jcmp.20254320
经阴道四维子宫输卵管超声造影中造影剂逆流风险预测模型的构建与验证
Construction and validation of a risk prediction model for contrast agent reflux in transvaginal four-dimensional hysterosalpingo-contrast sonography
摘要
Abstract
Objective To construct a risk prediction model for contrast agent reflux in transvagi-nal four-dimensional hysterosalpingo-contrast sonography(TVS-4D-HyCoSy)and validate its efficacy.Methods A total of 271 infertile patients who underwent TVS-4D-HyCoSy were retrospectively in-cluded as the study subjects.According to the presence or absence of contrast agent reflux in the ul-trasonic images,they were divided into observation group(121 cases)and control group(150 ca-ses).Clinical data of patients in the two groups were collected.Logistic regression analysis was used to screen the influencing factors of contrast agent reflux and construct a prediction model.The goodness-of-fit between the prediction model and the observed data was evaluated using the Hosmer-Lemeshow test.The receiver operating characteristic(ROC)curve was plotted to analyze the predictive effica-cy of the model,and the area under the curve(AUC)was calculated to quantify the discriminatory ability.Results There were statistically significant differences between the two groups in terms of infertility type,injection pressure,fallopian tube patency,history of previous uterine cavity surgery,intrauterine adhesion,and myometrial echo uniformity(P＜0.05).Multivariate Logistic regression analysis showed that injection pressure(OR=1.840,95％CI,1.336 to 2.790),fallopian tube pa-tency(OR=3.411,95％CI,2.576 to 4.728),history of previous uterine cavity surgery(OR=4.522,95％CI,3.682 to 5.085),intrauterine adhesion(OR=1.893,95％CI,1.416 to 2.951),and myometrial echo uniformity(OR=2.380,95％CI,1.683 to 3.584)were independ-ent influencing factors for the occurrence of contrast agent reflux(P＜0.05).A Logistic regression prediction model was constructed based on the independent influencing factors.The ROC curve showed that the AUC of the model for predicting contrast agent reflux was 0.836(95％CI,0.647 to 0.911),with a sensitivity of 93.02％and a specificity of 86.41％.The Hosmer-Lemeshow test showedx2=4.326,P=0.503,indicating good predictive efficacy of the model.Conclusion In-jection pressure,fallopian tube patency,history of previous uterine cavity surgery,intrauterine ad-hesion,and myometrial echo uniformityare independent influencing factors for the occurrence of con-trast agent reflux during TVS-4D-HyCoSy in infertile patients.The constructed risk prediction model for contrast agent reflux based on these factors shows good fit and can provide an accurate tool for risk assessment of contrast agent reflux,enhancing the safety and efficacy of the examination.关键词
不孕症/经阴道四维子宫输卵管超声造影/造影剂逆流/风险预测模型/输卵管通畅性/宫腔粘连/肌层回声/Logistic回归模型Key words
infertility/transvaginal four-dimensional hysterosalpingosalpingography/contrast agent reflux/risk prediction model/fallopian tube patency/intrauterine adhesion/myometrial echo/Logistic regression model分类
医药卫生引用本文复制引用
刘玉君,巫晶晶,黄卫车,饶媚,谭茁杰,杨千慧,吴慧琳,农务荣,何剑丽..经阴道四维子宫输卵管超声造影中造影剂逆流风险预测模型的构建与验证[J].实用临床医药杂志,2025,29(23):42-47,6.基金项目
广西壮族自治区卫生健康委自筹经费科研课题(Z-A20241028) （Z-A20241028）
