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。 Objective: To study the coincidence rate and diagnostic consistency of different physicians in the diagnosis of hysterosalpingography. Methods: Sixty cases of patients undergoing laparoscopic surgery were selected and diagnosed by four clinicians. The diagnostic results were divided into hydronephrosis, proximal tubal obstruction, distal tubal obstruction, pelvic adhesions and endometrial polyps. The coincidence rate and consistency of diagnostic results of each physician and the results of laparoscopy and uterus were analyzed respectively ). Results: The diagnostic rates of congenital tubal hydrops were 83.33% ~ 100.00% and 97.22% ~ 98.15%, respectively. The sensitivity of proximal tubal obstruction was 75.00% ~ 83.33% and the specificity was 88.89% ~ 92.60% The sensitivities of obstruction were 85.71% -92.86% and the specificity were 77.78% -81.11%. The sensitivity of endometrial polyps was 12.50% -25.00% and the specificity was 94.23% -100.00%. The sensitivity of pelvic adhesion was 58.93% -64.26% and the specificity was 45.31 % ~ 64.06%. The diagnostic consistency of each physician (κ): hydrosalpinx was 0.758, proximal tubal obstruction was 0.815, distal tubal obstruction 0.277, pelvic adhesions 0.431, endometrial polyps 0.658. Conclusions: The coincidence rate of diagnosis of tubal hydrops by contrast is high. Diagnosis of proximal obstruction and endometrial polyp is not easy to be misdiagnosed, but it is easy to misdiagnosis. Diagnosis of distal obstruction is not easy to misdiagnosis, but it is easy to be misdiagnosed. Sensitivity and specificity of diagnosing pelvic adhesions are low , The clinical value is limited. Different physicians diagnosed the proximal tubal obstruction and tubal hydrops consistency is higher, the diagnosis of distal tubal obstruction and pelvic adhesions consistency is low.