Objective:To evaluate the qualitative and quantitative diagnostic value of transvaginal contrast-enhanced ultrasonography for benign and malignant adnexal masses.Methods:Forty-nine patients with adnexal masses detected by routine ultrasound examination at Wenzhou People's Hospital from January 2021 to December 2022 were included in this study. Initially, transvaginal two-dimensional ultrasound, two-dimensional ultrasound integrated with color Doppler, and contrast-enhanced ultrasonography were used to accurately classify the masses as benign or malignant. Using postoperative pathology as the gold standard, the qualitative diagnostic accuracy of various detection methods was compared. Subsequently, the receiver operating characteristic curve analysis was performed to assess the quantitative diagnostic accuracy of transvaginal contrast-enhanced ultrasonography-related parameters in distinguishing between benign and malignant adnexal masses.Results:Among the 49 patients, 10 were diagnosed with malignant tumors. The diagnostic accuracy of contrast-enhanced ultrasonography was 93.88% (46/49), with a sensitivity of 90.00% (9/10), a specificity of 94.87% (37/39), a positive predictive value of 81.82% (9/11), and a negative predictive value of 97.37% (37/38). The results of the diagnostic difference assessment (McNemar test) revealed that there was no significant difference between two-dimensional ultrasound ( χ2 = 0.37, P = 0.546), two-dimensional ultrasound combined with color Doppler ( χ2 = 0.17, P = 0.683), and contrast-enhanced ultrasonography ( χ2 = 0.00, P = 1.000), and the gold standard test results. The consistency assessment (Kappa test) revealed that the diagnostic results of contrast-enhanced ultrasonography exhibited the highest concordance with the gold standard, with a Kappa value of 0.82 ( P < 0.001). Furthermore, the receiver operating characteristic curve analysis indicated that the initial increase time, peak intensity, and mean transit time in contrast-enhanced ultrasonography demonstrated high quantitative diagnostic accuracy. The areas under the curve were 0.83, 0.82, and 0.84, respectively, and the diagnostic cutoff values were 17.30 s, 21.65 dB, and 92.60 seconds, respectively. Conclusion:Contrast-enhanced ultrasonography exhibits diagnostic value in the differential diagnosis of benign and malignant adnexal masses, both qualitatively and quantitatively. This method can provide valuable insights for further treatment.

Objective To assess the clinical value of three-dimensional hysterosalpingo-contrast sonography (3D Hy-CoSy)in patients with tubal infertility. Methods A total of 274 patients with infertility(totally 539 the fallopian tubes)from September 2011 to March 2013 in our hospital,all patients were choose 3~7 days after menstruation clean,Transvaginal three-dimensional ultrasound imaging by injecting SonoVue through the uterine tube,with dynamic obser-vation of fallopian tube in imaging mode,by adopting of transvaginal three-dimensional ultrasound imaging reconstruc-tion technology evaluate tubal patency. The result of transvaginal three-dimension ultrasound imaging among 67 cases were compared with laparoscopic Meilan hydrotubation or X-ray hysterosalpingography (HSG). Results Among 539 oviducts, 230 oviducts were diagnosed patency by HyCoSy,224 oviducts were incompletehy obstructed, and 85 oviducts were completely obstructed among which 7 were hydrosalpinx; 3 out of 274 cases were contrast medium reflux into myometrium and venous plexus nearby; The sensitivity of 3D HyCoSy was 86.67%,which compared with the re-sults of HSG and laparoscopy,specificity was 100%,positive predictive value was 96.30%, negative predictive value was 98.25%. Conclusion 3D-HyCoSy in the diagnosis of fallopian tube patency is simple, safety and effective,fully and accurately displaying the shape of uterine tube . This technique is hopeful to become an effective method to diag-nose patients with tubal infertility.