Abstract
OBJECTIVE: To investigate the application value of multimodal hysterosalpingo-contrast sonography (HyCoSy) combined with negative hysterography in assessing tubal patency and diagnosing uterine lesions. METHODS: A total of 310 infertility patients were selected and examined using multimodal HyCoSy and negative hysterography to evaluate tubal patency and uterine lesions. Based on the doctors' experience levels, they were divided into high seniority group (more than 5 years of experience in Contrast-enhanced ultrasound) and low seniority group (resident doctors). Various ultrasound modes, including two-dimensional contrast-enhanced ultrasound (2D), static three-dimensional contrast-enhanced ultrasound (3D), real-time three-dimensional contrast-enhanced ultrasound (4D), and transvaginal harmonic imaging (HI), were employed for diagnosis. The χ2 test was used to compare the success rates of tubal patency diagnosis across different mode combinations. The Wilcoxon rank-sum test was used to compare the diagnostic efficiency of tubal patency between high and low seniority groups under multimodal ultrasound. RESULTS: A total of 306 patients successfully completed the examinations, with 538 cases of tubal patency and 74 cases of obstruction identified. The combination of multiple modalities significantly improved diagnostic efficiency, with the 4D + 3D + 2D + HI mode demonstrating a significantly higher diagnostic success rate compared to single modes (P < 0.005). Negative hysterography showed high consistency with hysteroscopy in diagnosing uterine malformations, with 100% sensitivity and specificity. Additionally, it demonstrated good diagnostic ability for cesarean scar diverticulum, endometrial polyps, submucosal fibroids, and uterine adhesions. CONCLUSION: The combination of multimodal HyCoSy and negative hysterography is a simple, rapid, and accurate examination method suitable for assessing tubal patency and diagnosing uterine lesions.