三维能量多普勒超声在多囊卵巢综合征诊断中的应用研究  

Study on the application of three-dimensional power Doppler ultrasonography in diagnosis of polycystic ovary syndrome

作　　者：陈鸿雁[1] 朱文斌[1] 李科珍[2] 

机构地区：[1]华中科技大学同济医学院附属普爱医院超声科,湖北武汉430033 [2]华中科技大学同济医学院附属同济医院妇产科,湖北武汉430033

出　　处：《中国妇幼保健》2016年第6期1282-1284,共3页Maternal and Child Health Care of China

基　　金：湖北省自然科学基金资助项目(2010CDB09403)

摘　　要：目的运用三维能量多普勒超声,观察测量多囊卵巢综合征(PCOS)患者卵巢内血流分布和血流指标,评价三维能量多普勒血流指标在诊断PCOS中的诊断价值。方法选取2013年5月-2014年12月在该院妇科门诊就诊的患者80例为研究对象,分为PCOS组40例和对照组40例,观察两组患者卵巢的三维能量多普勒血流成像,并测量卵巢三维能量多普勒血流指标,包括血管指数(VI)、血流指数(FI)和血管化血流指数(VFI)。并检测血清性激素水平,包括睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)。分析各项三维能量多普勒血流指标和性激素水平的相关性,并应用接受者操作特性曲线(ROC曲线)分析各项三维血流指标的诊断价值。结果 PCOS组卵巢内血流数量丰富,血流信号呈长棒状或树枝状。PCOS组的VI、FI和VFI显著高于对照组,差异有统计学意义(P<0.05或P<0.001)。VI、VFI与LH/FSH水平呈正相关关系(r=0.487,P<0.01;r=0.437,P<0.01)。FI与LH/FSH无显著相关。VI、FI、VFI与LH水平均呈正相关关系(r=0.324,P<0.05;r=0.339,P<0.05;r=0.384,P<0.05)。VI、FI、VFI与T和FSH均无显著相关。利用ROC曲线,VI、FI、VFI的ROC曲线下面积(AUC)分别为0.867,0.651和0.851。因此VI、FI、VFI均可用于诊断PCOS,其中VI和VFI诊断价值较高。VI的截断值为7.27%时,敏感性68%,特异度85%;FI的截断值为34.48%时,敏感性70%,特异性65%;VFI的截断值为2.40%时,敏感性为73%,特异性为85%。结论三维能量多普勒超声能观察和定量评价卵巢内血流分布和血流灌注情况,具有较高的诊断价值,可为PCOS的临床诊断提供更多参考。Objective To observe ovarian blood flow distribution and blood flow parameters of patients with polycystic ovary syndrome（ PCOS） by three-dimensional power Doppler ultrasonography,evaluate the diagnostic value of three-dimensional power Doppler ultrasonic parameters in diagnosis of PCOS. Methods Eighty patients were selected from Outpatient Department of Gynecology in the hospital from May 2013 to December 2014,then the cases were divided into PCOS group and control group,40 cases in each group. Three-dimensional power Doppler blood flow imaging of ovary in the two groups was observed,the parameters were measured,including vascularization index（ VI）,flow index（ FI）,and vascularization flow index（ VFI）. Serum levels of testosterone（ T）,luteinizing hormone（ LH）,follicle stimulating hormone（ FSH）,and estradiol were measured. The correlations between the parameters and sex hormones levels were analyzed,receiver operating characteristic（ ROC） curve was used to analyze the diagnostic value of blood flow parameters of three-dimensional power Doppler ultrasonography. Results Plentiful blood flow was observed in ovary of PCOS group,the blood flow signals showed long rod or dendritic shape. VI,FI,and VFI in PCOS group were statistically significantly higher than those in control group（ P〈0.05 or P〈0. 001）. VI and VFI were positively correlated with LH / FSH significantly（ r = 0. 487,P〈0.01; r = 0. 437,P 0. 01）,there was no significant correlation between FI and LH / FSH. VI,FI,and VFI were positively correlated with LH level（ r = 0. 324,P 0. 05; r = 0. 339,P 0. 05; r =0. 384,P〈0.05）,there was no significant correlation between VI,FI,VFI and T,FSH levels. The areas under ROC curve（ AUC） of VI,FI,and VFI were 0. 867,0. 651,and 0. 851,respectively. VI,FI,and VFI could be used to diagnose PCOS,the diagnostic value of VI and VFI is high. When the cut-off value of VI was 7. 27%,the sensitivity and specificity were 68% and 85%,respectively; when the cutoff value of FI was 34

关 键 词：三维超声 多囊卵巢综合征 能量多普勒 

分 类 号：R737.33[医药卫生—肿瘤]