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目的探讨经阴道三维超声在多囊卵巢综合征(PCOS)辅助诊断中的应用价值。方法选取2014—2015年易县医院收治的64例PCOS患者(观察组)和因输卵管疾病或其他因素引起的不孕症患者56例(对照组)。两组患者均进行经阴道三维超声检查,记录并比较两组患者卵巢形态学指标[包括卵巢体积(OV)、卵泡数(FN)、卵巢间质面积(SA)、卵巢总面积(TA)、SA/TA、最大卵泡直径]及卵巢动脉的血流动力学指标[包括舒张末期血流速度(EDV)、收缩期峰值血流(PSV)、阻力指数(RI)及搏动指数(PI)]。结果观察组患者超声检查结果显示两侧卵巢体积均匀增大(>10ml),且呈多囊样改变(>12个小囊);间质回声增强,血流比较丰富,血管分布面积增大,动脉血流RI降低。观察组OV、FN、SA、TA、SA/TA指标均大于对照组,最大卵泡直径小于对照组,差异有统计学意义(P<0.05)。超声显示观察组患者卵巢间质内血管数量丰富,有一支贯穿卵巢间质的大血管;血流频谱表现为高速低阻波形;对照组患者卵巢间质内血流稀疏,血流信号弱;血流频谱表现为波峰尖锐的波形。观察组EDV、PSV指标大于对照组,PI、RI指标低于对照组,差异有统计学意义(P<0.05)。结论经阴道三维超声检查卵巢,若卵巢体积增大、多囊性改变、间质容积增大,且卵巢内血流丰富,呈高速低阻型血流频谱,则能辅助诊断PCOS。
Objective To investigate the value of transvaginal three-dimensional ultrasound in the diagnosis of polycystic ovary syndrome (PCOS). Methods Sixty-four patients with PCOS (observation group) and 56 infertility patients (control group) due to tubal disease or other factors were selected from Yixian Hospital in 2014-2015. Transvaginal three-dimensional ultrasonography was performed in both groups. Morphology (including ovarian volume (OV), number of follicles (FN), ovarian stromal area (SA), total ovarian area (TA) SA / TA, the diameter of the largest follicle] and the indexes of hemodynamics (including EDV, PSV, RI and PI) in ovarian artery. Results The results of ultrasonography in observation group showed that the volume of ovaries on both sides increased uniformly (> 10ml) and showed polycystic change (> 12 small sacs). The interstitial echogenicity was enhanced, the blood flow was relatively abundant, the area of blood vessels was increased, RI decreased arterial blood flow. The indexes of OV, FN, SA, TA, SA / TA in the observation group were larger than those in the control group, and the diameter of the largest follicle in the observation group was smaller than that in the control group (P <0.05). Ultrasound showed that the observation group of patients with abundant ovarian stromal blood vessels, there is a large blood vessels throughout the ovarian stroma; blood flow spectrum showed high-speed low resistance waveform; control group of patients with sparse interstitial blood flow, weak blood flow signal; blood The flow spectrum shows a sharp peak waveform. The EDV and PSV indexes in the observation group were higher than those in the control group, while the indexes of PI and RI in the observation group were lower than those in the control group (P <0.05). Conclusion Ovarian transvaginal three-dimensional ultrasound examination, if the ovarian volume increases, polycystic change, interstitial volume increased, and rich in blood flow in the ovary, was high-speed low resistance blood flow spectrum, can help diagnose PCOS.