摘要
目的应用经阴道三维能量多普勒超声(3D-PDI)联合二维剪切波弹性成像(2D-SWE)评估备孕女性子宫内膜容受性,探讨其预测妊娠结局的临床应用价值。方法选取在我院接受卵泡检测的87例备孕女性,均于排卵第7~8天(种植窗期)行经阴道3D-PDI检查,于增殖期行2D-SWE检查,然后随访6周,根据妊娠结局将其分为受孕组31例和未受孕组56例。比较两组子宫内膜厚度、容积、回声类型、血流分型、子宫螺旋动脉搏动指数(PI)、阻力指数(RI)、收缩期峰值流速与舒张末期流速比值(S/D)、血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI),以及子宫内膜杨氏模量平均值(以下简称杨氏模量值)的差异。绘制受试者工作特征(ROC)曲线分析经阴道3D-PDI和2D-SWE参数单独及联合应用对备孕女性妊娠结局的预测价值。结果受孕组子宫内膜厚度和FI均高于未受孕组,S/D和子宫内膜杨氏模量值均低于未受孕组,差异均有统计学意义(均P<0.05);两组子宫内膜容积、回声类型、血流分型及PI、RI、VI、VFI比较差异均无统计学意义。ROC曲线分析显示,子宫内膜厚度、FI、S/D和子宫内膜杨氏模量值预测备孕女性妊娠结局的曲线下面积分别为0.789、0.851、0.853和0.840,联合应用的曲线下面积为0.895,高于各参数单独应用,差异均有统计学意义(均P<0.05)。结论经阴道3D-PDI联合2D-SWE可准确评估备孕女性子宫内膜容受性,对预测其妊娠结局有较好的临床应用价值。
Objective To evaluate the endometrial receptivity(ER)by transvaginal three-dimensional power Doppler imaging(3D-PDI)combined with two-dimensional shear wave elastography(2D-SWE)in women preparing for pregnancy,and to explore the clinical value in predicting conception outcomes.Methods A total of 87 women preparing for pregnancy underwent follicular test in our hospital were enrolled.All underwent transvaginal 3D-PDI on the 7th~8th day after ovulation(implantation window period),2D-SWE was performed in the proliferation period,then they were followed up for 6 weeks.According to conception outcomes,they were divided into conception group(31 cases)and non-conception group(56 cases).The endometrial thickness,volume,types of endometrial echoes,classifications of endometrial blood flow,pulsatility index(PI)of spiral artery,resistance index(RI),ratio of peak systolic velocity and end-diastolic velocity(S/D),vascularization index(VI),flow index(FI),vascularization flow index(VFI)and endometrial Young’s modulus were compared between the two groups.The predictive value of transvaginal 3D-PDI combined with 2D-SWE parameters alone and in combined for conception outcomes in women preparing for pregnancy was analyzed by receiver operating characteristic(ROC)curve.Results The endometrial thickness and FI of the conception group were higher than those of the non-conception group,while the S/D and endometrial Young’s modulus were lower than those of the non-conception group(all P<0.05).There were no significant differences in endometrial volume,types of endometrial echoes,classifications of endometrial blood flow,PI,RI,VI and VFI between the two groups.ROC curve analysis showed that area under the curve(AUC)of endometrial thickness,FI,S/D and endometrial Young’s modulus for predicting conception outcomes in women preparing for pregnancy were 0.789,0.851,0.853 and 0.840,respectively.AUC of combined application was 0.895,which was higher than that of single parameter(all P<0.05).Conclusion Transvaginal 3D-PDI combined with 2D-SWE can accurately evaluate ER in women preparing for pregnancy,which has better clinical application value in predicting conception outcomes.
作者
冯菲
李瑞霞
孟文玉
陈高进
张文霞
陈飞
FENG Fei;LI Ruixia;MENG Wenyu;CHEN Gaojin;ZHANG Wenxia;CHEN Fei(Department of Ultrasound Medicine,the First Hospital of Lanzhou University,Lanzhou 730000,China)
出处
《临床超声医学杂志》
CSCD
2024年第3期223-228,共6页
Journal of Clinical Ultrasound in Medicine
基金
甘肃省自然科学基金项目(22JR5RA922)。
关键词
超声检查
经阴道
能量多普勒
三维
剪切波弹性成像
二维
备孕女性
子宫内膜容受性
妊娠结局
Ultrasonography,transvaginal
Power Doppler,three-dimensional
Shear wave elastography,twodimensional
Women preparing for pregnancy
Endometrial receptivity
Conception outcomes
