超微血管成像联合宫腔镜评估反复移植失败不孕症患者子宫内膜的应用价值  

Application value of ultrasonographic microvascular imaging combined with hysteroscopy for evaluating endometrium in patients with infertility after repeated transplantation failure

作　　者：周巧兰[1] 冯玉环[2] 晏红伟 ZHOU Qiaolan;FENG Yuhuan;YAN Hongwei(Department of Ultrasound,Tangshang Municipal Maternal and Child Health Care Hospital,Tangshan,Hebei 063000,China;Department of Reproductive Genetics,Tangshang Municipal Maternal and Child Health Care Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]河北省唐山市妇幼保健院超声科,063000 [2]河北省唐山市妇幼保健院生殖遗传科,063000

出　　处：《重庆医学》2021年第12期2038-2040,共3页Chongqing medicine

基　　金：河北省医学科学研究课题项目(20201483)。

摘　　要：目的探讨超微血管成像联合宫腔镜评估反复移植失败不孕症患者子宫内膜的应用价值。方法回顾分析76例反复移植失败不孕症患者的子宫内膜资料。常规超声检查评估子宫内膜基本情况,血流增强显示模式评估内膜血流情况。后行宫腔镜检查评估宫腔情况。结果29例内膜有炎性反应者检出22例Ⅲ型内膜血流,其检出率(75.9%)明显高于单独超声Ⅲ型内膜血流检出率(55.3%)。53例患者根据宫腔镜观察内膜颜色苍白与否分为观察组(疑似子宫内膜血供差)21例,对照组(血供正常)32例。观察组和对照组患者子宫内膜厚度分别为(5.62±0.19)mm、(6.62±0.43)mm,差异有统计学意义(P<0.05)。两组各型内膜血流检出率比较差异有统计学意义(P<0.05)。两组患者子宫动脉的搏动指数(PI)和脐动脉血流阻抗值(S/D)分别为3.58±0.21、4.41±0.31,3.61±0.26、4.56±0.28,差异无统计学意义(P>0.05)。宫腔镜疑似子宫内膜血供差者Ⅰ型内膜血流检出率(52.4%)明显高于单独超声Ⅰ型内膜血流的检出率(23.7%)。结论宫腔镜和超微血管成像在评估反复移植失败患者增生期子宫内膜方面各具优势,二者联合应用可为子宫内膜的评价提供更精准的参考信息。Objective To explore the application value of ultrasonographic microvascular imaging(MSI)combined with hysteroscopy for the evaluation of endometrium in the patients with infertility after repeated transplantation failure.Methods The endometrial data of 76 infertile women who failed in repeated transplantation were analyzed retrospectively.The basic condition of endometrium was assessed by conventional ultrasound,and the blood flow of endometrium was assessed by the blood enhanced display mode,then the condition of uterine cavity was assessed by hysteroscopy.Results In 29 cases of endometrial inflammatory reaction,22 cases of typeⅢendometrial blood flow were detected out,the detected rate was 75.9%,which was significantly higher than 55.3%by single ultrasound.Fifty-three cases were divided into the observastion group(suspected poor endomedial blood supply,21 cases)and control group(normal blood supply,32 cases)according to whether the endomedial color being pale.The thickness of endometrium in the observation group and control group was(5.62±0.19)mm and(6.62±0.43)mm respectively,and the difference was statistically significant(P<0.05);the detection rate of various types of endometrial blood flow had statistical difference between the two groups(P<0.05).PI and S/D of uterine artery in the two groups were 3.58±0.21,4.41±0.31,3.61±0.26 and 4.56±0.28 respectively,and the differences were not statistically significant(P>0.05);the detection rate of typeⅠendometrial blood flow in the patients with suspected endometrial poor blood supply by hysteroscopy was 52.4%,which was significantly higher than 23.7%by single ultrsound.Conclusion Hysteroscopy and MSI have their own advantages in the evaluation of proliferative endometrium in the patients with repeated transplantation failure.Their combination application can provide more accurate reference information for the evaluation of endometrium.

关 键 词：超声 超微血管成像 宫腔镜 子宫内膜 子宫动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学]