三维超声联合三维能量多普勒超声评估子宫腺肌病不孕患者子宫内膜-肌层交界区预测体外受精-胚胎移植妊娠结局  

Three-dimensional ultrasound combined with three-dimensional power Doppler ultrasound evaluation of endometrial-myometrial interface in infertility patients with adenomyosis for predicting pregnancy outcome of in vitro fertilization-embryo transfer

作　　者：卢佳 胡兵[1] 谢敏敏 丁凌[1] 杨莹 LU Jia;HU Bing;XIE Minmin;DING Ling;YANG Ying(Department of Ultrasonic Imaging,Affiliated Renhe Hospital of China Three Gorges University,Yichang 443001,China)

机构地区：[1]三峡大学附属仁和医院超声影像科,湖北宜昌443001

出　　处：《中国介入影像与治疗学》2023年第8期473-477,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：宜昌市医疗卫生研究项目(A22-2-056)。

摘　　要：目的观察三维超声联合三维能量多普勒超声(3D-PDUS)评估子宫腺肌病(AD)不孕患者子宫内膜-肌层交界区(EMI)形态及血流用于预测体外受精-胚胎移植(IVF-ET)妊娠结局的价值。方法回顾性分析160例接受IVF-ET的不孕妇女,其中60例合并AD(AD组)、100例为单纯不孕(对照组),均于移植日接受三维超声联合3D-PDUS检查;比较组间及AD组内妊娠(23例)与未妊娠亚组(37例)移植日EMI超声参数,采用二元logistic回归分析筛选AD患者妊娠结局的独立影响因素,以受试者工作特征(ROC)曲线评估其预测IVF-ET妊娠结局的效能。结果AD组移植日EMI形态异常比例高于、血流指数(FI)低于对照组(P均<0.05)。AD组内妊娠亚组EMI平均厚度、容积、血管化指数(VI)、血流指数FI、血管化血流指数(VFI)均高于,而形态异常比例低于未妊娠亚组(P均<0.05)。多因素logistic回归分析结果显示,EMI容积[OR=0.240,95%CI(0.105,0.551),P<0.05]及VFI[OR=0.051,95%CI(0.008,0.334),P<0.05]均与AD患者IVF-ET妊娠结局独立相关。ROC曲线显示,以EMI容积及VFI预测AD患者妊娠结局的曲线下面积(AUC)分别为0.776及0.761。结论三维超声联合3D-PDUS观察AD不孕患者EMI形态及血流可有效预测其IVF-ET妊娠结局。Objective To explore the value of three-dimensional(3D)ultrasound combined with three-dimensional power Doppler ultrasound(3D-PDUS)evaluation on the morphology and blood flow of endometrial-myometrial interface(EMI)in infertility patients with adenomyosis(AD)for predicting pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET).Methods Data of 160 infertile women of childbearing age,including 60 cases with AD(AD group)and 100 cases of simple infertility(control group)who underwent IVF-ET were retrospectively analyzed.3D ultrasound combined with 3D-PDUS examinations were performed on the transplantation day,and the ultrasound parameters were compared between groups,also between pregnant subgroup(n=23)and non-pregnant subgroup(n=37)within AD group.The independent impact factors of pregnancy outcome in patients with AD were screened with binary logistic regression analysis,and the efficacy of them for predicting pregnancy outcome were evaluated with receiver operating characteristic(ROC)curve.Results On the day of embryo transfer,the proportion of abnormal morphology of EMI in AD group was higher,while flow index(FI)was lower than those in control group(both P<0.05).In AD group,the average EMI thickness,volume,vascularization index(VI),FI and vascularization blood flow index(VFI)of pregnant subgroup were all higher than those of non-pregnant subgroup(all P<0.05).Multivariate logistic regression analysis showed that the volume of EMI(OR=0.240,95%CI[0.105,0.551],P<0.05)and VFI of EMI(OR=0.051,95%CI[0.008,0.334],P<0.05)were independently correlated with pregnancy outcome of IVF-ET in patients with AD.Receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of the volume and VFI of EMI for predicting pregnancy outcome of IVF-ET in patients with AD was 0.776 and 0.761,respectively.Conclusion 3D ultrasound combined with 3D-PDUS could effectively predict pregnancy outcome of IVF-ET in AD infertility patients through evaluating EMI morphology and blood flow.

关 键 词：子宫腺肌病 超声检查 体外受精-胚胎移植 不孕 

分 类 号：R711.71[医药卫生—妇产科学] R445.1[医药卫生—临床医学]