摘要
目的 探讨经阴道或直肠三维超声自动体积测量（SonoAVC）技术在多囊卵巢综合征（PCOS）诊断中的价值.方法 使用SonoAVC技术分级计数80例PCOS患者（PCOS组）卵巢内的卵泡数,并测量卵巢体积,以60例输卵管或男性因素的不孕症患者为对照组;测定观察对象早卵泡期的血生殖激素水平,并分析PCOS患者卵泡数、卵巢体积和血生殖激素水平之间的关系.结果 PCOS 组患者的卵巢体积[（11 ±8）ml]、总卵泡数[（27±14）个]及直径≥2～＜6 mm卵泡数[（22±19）个]显著高于对照组[分别为（6 ±4）ml、（6 ±4）个及（2±3）个],分别比较,差异均有统计学意义（P＜0.05）;直径≥6～≤9 mm卵泡数与对照组类似,两组比较,差异无统计学意义（P＞0.05）.总卵泡数及直径≥2～＜6 mm卵泡数与卵巢体积呈正相关（相关系数分别为0.600、0.618,P＜0.01）,直径≥2～＜6 mm卵泡数与总卵泡数也呈正相关（相关系数为0.916,P＜0.01）;直径≥6～≤9 mm卵泡数与卵巢体积及总卵泡数呈负相关（相关系数分别为-0.618、-0.263,P均=0.001）;总卵泡数及直径≥2～＜6 mm卵泡数与血睾酮水平呈正相关（相关系数分别为0.364、0.291,P=0.001、P＜0.05）;卵巢体积与卵泡刺激素（FSH）水平呈负相关（相关系数为-0.226,P=0.042）,与黄体生成素（LH）/FSH比值呈正相关（相关系数为0.282,P=0.010）.结论 PCOS患者的卵巢体积、总卵泡数、直径≥2～＜6 mm卵泡数显著高于对照人群.卵巢体积越大,总卵泡数及直径≥2～＜6 mm卵泡数增多的可能性越大;血睾酮水平越高,总卵泡数增多的可能性越大,主要以直径≥2～＜6 mm小卵泡绝对增加为主.这些超声特征在一定程度上反映了PCOS患者卵巢的病理生理变化及相应的临床生化改变.SonoAVC卵泡计数法为PCOS患者提供了一种新的客观的卵泡计数方法,使用SonoAVC技术分级计数卵泡数对PCOS的诊断具有重要的临床意义.
Objective To investigate clinical significance of counting follicles classification by three-dimensional imaging with sonography based automated volume calculation（SonoAVC）in the diagnosis of polycystic ovary syndrome（PCOS）.Methods Eighty cases with PCOS were counted classified follicles and determined ovarian volume by three-dimensional（3D）imaging with SonoAVC method matched with 60 infertile women with fallopian tube or male factors as control.Main clinical.biological and other ultrasonographic markers were assessed during the early follicular phase,and the relationship between the follicle number range per ovary or the volume per ovary and the major hormonal features of PCOS was studied.Results Three-dimensional ultrasound imaging with SonoAVC methed provides a new path for objective quantitative assessment of follicle count.ovarian volume,total follicle numbers.The volume of （11 ±8）ml,total numbers of 27 ±14 follicle and number of22 ±19 follicle with diameter of≥2-〈6 mm in PCOS patients were significantly higher than（6 ±4）ml in ovarian volume.6 ±4 in total follicles and 2 ±3 in follicle with diameter of≥2-〈6 mm in controls（P〈0.05）.while follicles were similar for the≥6-≤9mm range（P〉0.05）.Total follicle numbers and follicles≥2-〈6 mm had significantly positive relationships with ovarian volume （ r= 0. 600, 0. 618, P〈0. 01 ） and level of testosterones （ r= 0. 364,0. 291, P〈0.05）, follicles ≥2-〈6 mm also had significantly positive relationships with total follicle number （r=0. 916,P〈0. 01 ）. The follicles within the ≥6 - ≤9 mm range was significantly and negatively related to ovarian volume and total follicle numbers （ r = - 0. 618, - 0. 263, all P = 0. 001 ）, but no significantly related to the major hormonal features of PCOS. The ovarian volume was significantly positively related with luteinizing hormone （ LH）/follicle stimulating hormone （FSH） ratio （ r= 0. 282, P = 0. 010）but negatively related to FSH level （r = - 0. 226, P = 0. 042）. Conclusions Ovarian volume, total follicle numbers and follicles ≥2 - 〈6 mm in PCOS patients were significantly higher than those in controls. The larger ovarian volume might produce more total follicle and follicles ≥ 2 - 〈6 mm. The higher level of testosterone might produce more total follicle probably, which mainly result in more follicles ≥2 -〈6 mm.These morphologically ultrasonographic characteristics could reflect pathophysiological changes in PCOS. Obviously, it has important clinical significance to count follicles in patients with PCOS by the threedimensional ultrasound imaging with SonoAVC method.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2011年第5期350-354,共5页
Chinese Journal of Obstetrics and Gynecology
关键词
多囊卵巢综合征
成像
三维
超声检查
卵泡
Polycystic ovary syndrome
Imaging, three-dimensional
Ultrasonography
Ovarian follicle
