Abstract：Objective To explore the clinical value of real-time harmonic ultrasonography combined with transvaginal 4-dimensional
hysterosalpingo-contrast sonography (TVS 4D-HyCoSy) in salpingography. Methods A total of 50 infertile women were
retrospectively analyzed. TVS 4D-HyCoSy was performed first, and then real-time harmonic contrast-enhanced ultrasound was
performed. The value of real-time harmonic contrast-enhanced ultrasound combined with TVS 4D-HyCoSy and TVS 4D-HyCoSy in
evaluating tubal patency was compared with that of laparoscopic methylene blue hydrotubation. Results The accuracy,
sensitivity, specificity, positive predictive value and negative predictive value of real-time harmonic contrast-enhanced ultrasound combined
with TVS 4D-HyCoSy and TVS 4D-HyCoSy in evaluating tubal patency were 93%, 90%, 93%, 92%, 95% and 72%, 64%, 77%, 64% ,77%,
respectively. The results of consistency analysis showed that the coincidence between TVS4D-HyCoSy and laparoscopic methylene blue
hydrotubation was basically the same (Kappa=0.412); the coincidence between real-time harmonic-enhanced contrast ultrasound combined
with TVS 4D-HyCoSy and laparoscopic methylene blue hydrotubation was highly consistent (Kappa=0.854). The results of real-time
harmonic contrast-enhanced ultrasound combined with TVS 4D-HyCoSy and TVS 4D-HyCoSy were significantly different (P<0.05). There
were significant statistical differences in the diagnosis of obstruction between the two methods (P<0.05). Conclusion The real-time
harmonic contrast-enhanced ultrasound combined with TVS 4D-HyCoSy can fully demonstrate the line of fallopian tubes, accurately
assess the unobstructed nature of fallopian tubes and minimize misdiagnosis.
