三维能量多普勒在评价排卵障碍患者子宫内膜容受性中的应用价值  

The role of three-dimensional power Doppler in evaluating endometrial receptivity of patients with anovulatory infertility

作　　者：牛琳 来蕾 黄坚 卓广超 

机构地区：[1]杭州市第一人民医院南京医科大学附属杭州医院超声科,浙江杭州310006 [2]杭州市第一人民医院南京医科大学附属杭州医院妇产科,浙江杭州310006 [3]杭州市第一人民医院南京医科大学附属杭州医院中心实验室,浙江杭州310006

出　　处：《医学影像学杂志》2018年第1期130-133,共4页Journal of Medical Imaging

基　　金：浙江省人口和计划生育科技项目(编号:JSW2013-A035)

摘　　要：目的探讨三维能量多普勒评价排卵障碍患者促排卵治疗中子宫内膜容受性的临床应用价值。方法选择2014年10月~2015年10月在我院就诊的不孕症妇女50例,所有患者均参与促排卵治疗,于注射HCG日应用三维阴道超声及三维能量多普勒进行检查,采集数据包括:子宫内膜容积、内膜血管指数(vascularization index,VI)、血流指数(flow index,FI)和血管血流指数(vascularization flow index,VFI)等参数。结果两组间一般情况比较,包括年龄、HCG日雌激素和孕激素水平等一般情况均无明显差异(P>0.05);两组间子宫内膜厚度及子宫内膜VI及FI也无统计学差异(P>0.05)。妊娠组子宫内膜容积及VFI均大于非妊娠组,且具有显著统计学意义(P<0.05)。在预测妊娠结局的效能方面,子宫内膜容积的ROC曲线下面积为0.686,截断值为4.86;其灵敏度和特异度分别为50.0%和87.5%。内膜VFI的ROC曲线下面积为0.698,截断值为4.58,其灵敏度和特异度分别为76.9%和50.0%。结论结果表明三维能量多普勒技术对评价排卵障碍患者促排卵治疗后子宫内膜容受性具有一定的预测价值,但尚需进一步深入的研究。Objective To investigate the value of three-dimensional power Doppler ultrasound （3D PDUS） parameters for the assessment of endometrial receptivity of patients with anovulatory infertility during ovulation induction treatment. Methods Be- tween October 2014 and October 2015, 50 patients with anovulatory infertility were recruited. All the patients were undergoing ovulation induction treatment. A 3D ultrasound examination was performed on the day of human chorionic gonadotropin （hCG） in- jection to determine endometrial thickness, endometrial volume, vascularization index （VI）, flow index （FI） and vascularization flow index （VFI） of endometrial region. Analyses were carried on between pregnant and non-pregnant groups. Results In the 50 patients, 18 patients were included in pregnant group and 32 patients were included in non-pregnant group. Patients in both preg- nant and non-pregnant groups did not show significant difference in endometrial thickness, endometrial vascularization index VI and endometrial flow index FI （ P 〉 O. 05）. There were significant differences in endometrial volume and endometrial vasculariza- tion flow index YFI （ P 〈 0.05） between two groups. ROC curve was applied to determine the predictive values of endometrial VFI and endometrial volume for pregnancy outcome. The AUC of the endometrial volume was O. 686, cut off value was 4.86 ; The AUC of the endometrial VFI was 0. 698, cut off value was 4.58. Conclusion 3D PDUS parameters of endometrium measured on hCG day can be predictors for the assessment of endometrial receptivity in evaluating endometrial receptivity of patients with anovulatory infertility during ovulation induction treatment.

关 键 词：子宫内膜容受性 排卵障碍 三维超声 能量多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.75[医药卫生—诊断学]