目的：探讨二次造影在评价输卵管通畅性方面的应用价值。方法：选取经阴道实时三维超声输卵管造影（TVS RT-3D-HyCoSy）显示为至少一侧输卵管阻塞或输卵管走行影像数据缺失的不孕症患者80例，行二次输卵管造影，其中40例行宫腹腔镜下通染液检查，并以其结果为金标准，比较一次造影与二次造影在评价输卵管通畅性方面有无差异；分析80例患者在两次造影中不良反应的分布情况。结果：①一次造影与二次造影在诊断输卵管通畅性方面的差异有统计学意义（P＝0.045）；②所有患者在两次造影过程中均未出现严重的不良反应，两组患者不良反应评分的差异无统计学意义（P=0.773）。结论：对于进行TVS RT-3D-HyCoSy检查过程中显示为输卵管阻塞、输卵管走行影像数据缺失的患者，有必要行二次造影检查，且二次造影不会加重患者的不良反应。

Objective: To evaluate the value of the second ultrasound contrast sonography in the assessment of fallopian tube patency. Methods: Eighty infertile women, who have been subjected to transvaginal real-time three-dimensionnal hysterosalpingo-contrast sonography(TVS RT-3D-HyCoSy) and shown at least one side of fallopian tube was obstructed, or part of fallopian tube imaging data were missed, were selected and subjected to the second ultrasound contrast sonography, and forty cases among them were subjected to hydrotubation under the Hysteroscopy-laparoscopy. The Hysteroscopy-laparoscopy results were used as the golden standard to compare the differences between the first contrast sonography and the second contrast sonography in assessing the fallopian tube patency, and analyze the distribution of the side effects in the two contrast sonography among the selected eighty cases. Results: ①There were significant differences in the diagnosis of fallopian tube patency between the first and the second contrast sonography(P=0.045). ②No severe side effect was observed during the two contrast sonography, and there was no significant difference in side effects score between the two groups(P=0.773). Conclusion: The second contrast sonography is necessary for the infertile women shown at least one side of fallopian tube was obstructed or part of fallopian tube imaging data were missed in the TVS RT-3D-HyCoSy without aggravating the side effects of patients.