摘要目的：研究不同医师对子宫输卵管造影的诊断符合率以及诊断一致性。方法：选取60例接受宫、腹腔镜手术患者的造影片,由4位临床医师读片诊断。诊断结果分成输卵管积水、输卵管近端阻塞、输卵管远端阻塞、盆腔粘连以及子宫内膜息肉,分别分析各医师的诊断结果与宫、腹腔镜诊断结果的符合率以及一致性(以κ值表示)。结果：造影诊断符合率分别为输卵管积水敏感度83.33%~100.00%,特异度97.22%~98.15%；输卵管近端阻塞敏感度75.00%~83.33%,特异度88.89%~92.60%；输卵管远端阻塞敏感度85.71%~92.86%,特异度77.78%~81.11%；子宫内膜息肉敏感度12.50%~25.00%,特异度94.23%~100.00%；盆腔粘连敏感度58.93%~64.26%,特异度45.31%~64.06%。各医师诊断一致性(κ值)：输卵管积水为0.758,输卵管近端阻塞为0.815,输卵管远端阻塞为0.277,盆腔粘连为0.431,子宫内膜息肉为0.658。结论：造影诊断输卵管积水符合率较高；诊断近端阻塞及子宫内膜息肉不易误诊,但易漏诊；诊断远端阻塞不易漏诊,但易误诊；诊断盆腔粘连敏感度及特异度均较低,临床价值有限。不同医师诊断输卵管近端阻塞和输卵管积水一致性较高,输卵管远端阻塞和盆腔粘连诊断一致性较低。

abstracts[ABSTRACT]Objective:To evaluate the diagnostic accuracy and interobserver reliability of hysterosalpingog-raphy (HSG). Methods:Totally, 60 patients’ HSG films were retrospectively read by four clinic doctors. The diagnosis included proximal tubal obstruction, distal tubal obstruction, hydrosalpinx, pelvic adhesion and endometrial polyp. The diagnostic accuracy and interobserver reliability of HSG were respectively analyzed. Results:The diagnostic sensitivity of hydrosalpinx was 83.33%-100.00%and specificity was 97.22%-98.15%. The diagnostic specificity of proxmal tubal obstruction was 88.89%-92.60%, however the sensitivity was 75.00%-83.33%. The diagnostic sensitivity of distal tubal obstruction was 85.71%-92.86%, however the specificity was only 77.78%-81.11%. The diagnostic specificity of endometrial polyp was 94.23%-100.00%, however the sensitivity was only 12.50%-25.00%. The diagnostic sensitivity of pelvic adhesion was 58.93%-64.26%, specificity was 45.31%-64.06%. Theκvalue of hydrosalpinx was 0.758, proximal tubal obstruction was 0.815, distal tubal obstruction was 0.277, pelvic adhesion was 0.431, endometrial polyp was 0.658. Conclusion:The diagnostic performance of HSG for hydrosalpinx is satisfactory. The diagnostic specificity of proxmal tubal obstruction and endometrial polyp is satisfactory, but the sensitivity is poor. The diagnostic sensitivity of distal tubal obstructionis satisfactory, but the specificity is poor. The diagnostic sensitivity and specificity of pelvic adhesion are both poor, so the HSG diagnostic value of pelvic adhesion is limited. Intrareader reliability is good for proximal tubal obstruction and hydrosalpinx, but poor for the distal tubal obstruction and pelvic adhesion.