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目的:探讨经腔内三维和彩色多普勒超声诊断多囊卵巢综合征(PCOS)的价值。方法:采用经阴道/直肠三维和彩色多普勒超声对16例PCOS患者、20例单纯卵巢多囊改变(PCO)患者和25例月经周期规则、有正常排卵者进行检查,分别测量卵泡数目、卵巢体积、卵巢总面积(TA)、髓质面积(SA)和髓质面积与卵巢总面积的比值(SA/TA),卵巢髓质内血流形态特征及其血流动力学指标,并进行对比分析。结果:经腔内三维和彩色多普勒超声对细致结构的显示优于经腹超声,且无创、方便、清晰、敏感,差异有统计学意义(P<0.05或P<0.01);收缩期峰值流速(PSV)高于对照组,差异有统计学意义(P<0.01);阻力指数(RI)搏动指数(PI)低于对照组,差异有统计学意义(P<0.01)。PCOS组卵巢髓质内血管显示清晰、数目丰富(100%),其中81.2%的卵巢可见1支纵向贯穿卵巢髓质的较粗的血管;正常对照组髓质内血流呈散在或细点状。结论:经腔内三维和彩色多普勒超声能提高诊断多囊卵巢综合征的准确率。
Objective: To investigate the value of three dimensional and color Doppler ultrasound in the diagnosis of polycystic ovary syndrome (PCOS). Methods: Transvaginal / rectal three-dimensional and color Doppler ultrasonography was used to examine 16 cases of PCOS, 20 cases of simple ovarian cystic change (PCO) and 25 cases of menstrual cycle, with normal ovulation. The number of follicles, Ovarian volume, total ovarian area (TA), medullary area (SA) and the ratio of medullary area to total ovarian area (SA / TA), blood flow morphological characteristics of the ovarian medulla and its hemodynamic parameters Comparative analysis. Results: Three-dimensional and color Doppler ultrasonography showed better detailed structure than transabdominal ultrasonography and was noninvasive, convenient, clear and sensitive. The difference was statistically significant (P <0.05 or P <0.01). The systolic peak The velocity of flow (PSV) was higher than that of the control group (P <0.01). The PI of the resistance index (RI) was lower than that of the control group. The difference was statistically significant (P <0.01). In the PCOS group, the blood vessels in the ovarian medulla showed a clear and abundant number (100%), of which 81.2% of the ovaries showed a thicker blood vessel penetrating the ovarian medulla longitudinally. The blood flow in the medulla of the normal control group was scattered or finely dotted. Conclusion: Three-dimensional and color Doppler ultrasound can improve the diagnostic accuracy of polycystic ovary syndrome.