经阴道三维超声成像在评估宫腔黏连分度和子宫内膜容受性中的应用价值及临床意义  

The application value and clinical significance of transvaginal three-dimensional ultrasound imaging in assessing the classification of intrauterine adhesions and endometrial receptivity

作　　者：朱丹[1] 陈燕华[1] 秦璐瑶 张冬梅 ZHU Dan;CHEN Yan-hua;QIN Lu-yao;ZHANG Dong-mei(Department of Ultrasound,Meishan People′s Hospital,Sichuan Province,Meishan 620010,China;Department of Ultrasound,Chengdu Women and Children′s Central Hospital,Sichuan Province,Chengdu 610000,China)

机构地区：[1]四川省眉山市人民医院超声科,四川眉山620010 [2]四川省成都市妇女儿童中心医院超声科,四川成都610000

出　　处：《河北医科大学学报》2024年第6期716-723,共8页Journal of Hebei Medical University

摘　　要：目的 探讨经阴道三维超声成像在评估宫腔黏连分度和子宫内膜容受性中的应用价值。方法 选取宫腔黏连患者76例作为研究对象,入院后均行经阴道三维超声成像检查,比较不同宫腔黏连分度、子宫内膜容受性评分患者经阴道三维超声检查参数[子宫动脉搏动指数(pulsatility index, PI)、阻力指数(resistance index, RI)、子宫内膜厚度(endometrial thickness, ET)、子宫内膜容积(endomembrane volume, EV)、内膜血管指数(vascular index, VI)、血流指数(flow index, FI)、血管血流指数(vascular flow index, VFIVFI)],分析各超声参数与宫腔黏连分度、子宫内膜容受性评分的相关性及评估价值,并随访1年,统计妊娠情况,对比妊娠与未妊娠患者超声参数。结果 重度黏连组和中度黏连组的PI、RI高于轻度黏连组,重度黏连组的PI、RI高于中度黏连组;重度黏连组和中度黏连组的ET、EV、VI、FI、VFI低于轻度黏连组,重度黏连组的ET、EV、VI、FI、VFI低于中度黏连组(P<0.05)。子宫内膜容受性评分≤3分组和4~6分组的PI、RI高于7~8分组,≤3分组的PI、RI高于4~6分组;≤3分组和4~6分组的ET、EV、VI、FI、VFI低于7~8分组,≤3分组的ET、EV、VI、FI、VFI低于4~6分组(P<0.05)。PI、RI与宫腔黏连分度呈正相关,与子宫内膜容受性评分呈负相关,ET、EV、VI、FI、VFI与宫腔黏连分度呈负相关,与子宫内膜容受性评分呈正相关(P<0.05);PI、RI、ET、EV、VI、FI、VFI鉴别轻度、中度黏连AUC分别为0.744、0.730、0.816、0.819、0.805、0.824、0.718,联合诊断AUC为0.914;鉴别中度、重度黏连AUC分别为0.802、0.783、0.750、0.751、0.742、0.758、0.807,联合诊断AUC为0.834;鉴别子宫内膜容受性差、一般AUC分别为0.790、0.778、0.717、0.847、0.777、0.754、0.799,联合诊断AUC为0.900;鉴别子宫内膜容受性一般、好的AUC分别0.809、0.829、0.741、0.712、0.795、0.781、0.847,联合诊断AUC为0.934;妊娠患者PI、RI小于Objective To investigate the application value of transvaginal three-dimensional ultrasound(3D-TVUS)imaging in assessing the classification of intrauterine adhesions(IUA)and endometrial receptivity(ER).Methods Seventy-six patients with IUA were selected as research subjects,and 3D-TVUS imaging was performed after admission to compare the 3D-TVUS parameters[uterine artery pulsatility index(PI),resistance index(RI),endometrial thickness(ET),endometrial volume(EV),endometrial vascular index(VI),blood flow index(FI),vascular flow index(VFI)]in patients with different scores of classifications of IUA and ER,and the correlation and assessment value of each ultrasound parameter with scores of classification of IUA and ER.They were followed up for 1 year to record the pregnancy and compare the ultrasound parameters between pregnant and non-pregnant patients.Results The PI and RI of the severe and moderate adhesion groups were higher than those of the mild adhesion group,and higher in the severe adhesion group than in the moderate adhesion group;ET,EV,VI,FI,and VFI of the severe and moderate adhesion groups were lower than those of the mild adhesion group,and lower in the severe adhesion group than in the moderate adhesion group(P<0.05).PI and RI were higher in ER score≤3 group and ER score 4-6 group than in ER score 7-8 group,and higher in ER score≤3 group than in ER score 4-6 group;ET,EV,VI,FI,and VFI were lower in ER≤3 group and ER score 4-6 group than in ER score 7-8 group,and lower in ER score≤3 group than in ER score 4-6 group(P<0.05).PI and RI were positively correlated with IUA score and negatively correlated with ER score;ET,EV,VI,FI,and VFI were negatively correlated with IUA score and positively correlated with ER score(P<0.05).The area under the receiver operating characteristic(AUC)curve(AUC)of PI,RI,ET,EV,VI,FI,and VFI for distinguishing mild and moderate IUA was 0.744,0.730,0.816,0.819,0.805,0.824,and 0.718,respectively,and the AUC of combined diagnosis was 0.914.The AUC of these indicators for dist

关 键 词：阴道闭锁 子宫内膜容受性 经阴道三维超声 

分 类 号：R711.73[医药卫生—妇产科学]