三维超声探讨LUFS患者卵巢基础状态及卵泡期血流灌注的研究

发布时间：2018-02-25 06:11

本文关键词： 黄素化未破裂卵泡综合症卵泡期卵巢血流三维能量多普勒超声　出处：《广州中医药大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：利用经阴道三维超声及VOCAL后处理软件对LUFS患者卵巢基础状态及卵泡期卵巢血流进行研究,评估LUFS患者的卵巢储备功能,探讨卵泡期LUFS发生的血流灌注特点。方法： 1、分析20例LUFS患者；以同期正常排卵者20例为对照组。 2、记录入选者的一般情况：包括年龄、身高、体重、不孕年限。 3、在卵泡早期(月经第3-5天)抽取基础性激素六项,在卵泡早期、卵泡中期(卵泡约12-16mm)、围排卵期(排卵前一天或预测排卵日前一天)行经阴道超声检查,在二维超声下测量入选者卵泡期的子宫内膜厚度、记录围排卵期子宫内膜类型；在能量多普勒模式下对双侧卵巢进行三维成像并储存三维数据,在VOCAL软件下对卵巢及成熟卵泡的轮廓进行描记,完成后自动算出卵巢体积、卵巢及成熟卵泡2mm范围内能量多普勒血流参数VI、FI、VFI,启动sonoAVC功能自动测量卵巢内所有窦卵泡数目及直径。 4、定量分析两组上述各项指标之间的差异。结果： 1、两组患者卵泡早期、中期及围排卵期内膜厚度比较差别无统计学意义。围排卵期LUFS组患者子宫内膜形态以B、C型为主；对照组患者子宫内膜形态则以A型主。 2、两组患者基础性激素FSH、LH、E2、P、PRL、T比较,差别均无统计学意义。两组中卵泡早期窦卵泡数目、卵巢体积、血流灌注参数VI、FI、VFI差别无统计学意义。 3、对照组优势侧卵巢血流参数VI、FI、VFI随着卵泡生长呈上升趋势,卵泡期3个阶段比较差别有显著性差异(均为P=0.000)；卵泡中期、围排卵期优势侧卵巢血流参数VI、FI、VFI与非优势侧卵巢比较差别有显著性差异(3者均P0.01),卵泡早期两组比较差别无明显统计学意义。 4、LUFS组优势侧卵巢血流参数VI、VFI在各期比较差别有统计学意义(分别为P=0.004, P=0.008), FI则无明显周期性波动(P=0.139)；LUFS组与对照组在卵泡中期及围排卵期血流参数VI、FI、VFI的差异均有统计学意义。围排卵期成熟卵泡壁2mm范围内血流参数Ⅵ与同组优势卵巢血流参数比较差别有统计学意义(P=0.045)、与对照组相应部位血流参数VI、FI、VFI匕较差异均有统计学意义(分别为P=0.000,P=0.017,P=0.000)。对照组成熟卵泡血流分级主要以3-4级为主,LUFS组血流分级多呈1-2级。结论： 1、LUFS患者卵巢储备功能与正常排卵者相近。 2、正常排卵者优势侧卵巢及优势卵泡周围的血流灌注参数VI、FI、VFI随着卵泡发育逐渐升高,提示正常成熟卵泡的成熟、排出需要丰富血供。 3、LUFS患者优势侧卵巢围排卵期血流较前丰富,但仍存在明显不足。其成熟卵泡壁周围血管数目较整个同侧卵巢丰富,但低于对照组成熟卵泡。新生血管数量少,血流量低可能是导致LUFS发生的血流特点。 4、经阴道三维能量多普勒超声在探测卵巢血流灌注方面具有独特优势,卵泡期进行经阴道三维扫查有助于早期识别病理性卵泡发育及排卵障碍。
[Abstract]:Objective:. The basic status of ovary and ovarian blood flow in follicular phase of LUFS patients were studied by transvaginal three-dimensional ultrasound and VOCAL post-processing software. The ovarian reserve function of LUFS patients was evaluated and the perfusion characteristics of LUFS in follicular phase were investigated. Methods:. 1. 20 cases of LUFS were analyzed, and 20 cases of normal ovulation were taken as control group. 2, record the general situation of the selected: including age, height, weight, infertility. 3. Six basic sex hormones were extracted early in the follicle (day 3-5 of menstruation), and transvaginal sonography was performed in the early follicle, in the middle of the follicle (about 12-16 mm of follicle, in periovulation period (the day before ovulation or the day before the predicted day of ovulation)). The thickness of endometrium in follicular phase was measured under two-dimensional ultrasound, and the type of endometrium in periovulation phase was recorded. Three-dimensional imaging of bilateral ovaries and storage of 3D data were performed in the mode of power Doppler. The outline of ovaries and mature follicles was recorded by VOCAL software. The volume of ovaries and the parameters of energy Doppler flow in 2 mm range of ovary and mature follicles were calculated automatically. The number and diameter of all antral follicles in ovary were measured automatically by initiating sonoAVC function. 4. Quantitative analysis of the difference between the two groups. Results:. 1. There was no significant difference in endometrial thickness between the two groups in early follicular stage, middle follicle stage and peri-ovulation stage. In LUFS group, the endometrial morphology was mainly type C in periovulatory phase, while that in control group was type A. (2) there was no significant difference in the number of antral follicles, ovarian volume and blood perfusion parameters (VIFI) between the two groups. 3. The VFI of the dominant side of the control group showed an increasing trend with follicular growth, and there were significant differences in the three stages of follicular stage (all P < 0.000, P < 0.05), and in the middle stage of follicle, there were significant differences between the three stages of follicular stage. There were significant differences in VFI and non-dominant ovaries between the two groups in periovulatory period (P 0.01), but there was no significant difference between the two groups in early follicular stage. 4 there were significant differences in VIFI between the LUFS group and the control group in all stages (P 0.004, P < 0.008), but there was no significant periodic fluctuation in fi between the LUFS group and the control group in the midfollicular and peri-ovulation stages. The VIFIVFI was significantly different between the two groups in the middle follicular stage and the periovulation stage (P < 0.05). The blood flow parameters of VIFIVFI in the midfollicular and periovulation stage were significantly different between the control group and the control group (P < 0.05). There were significant differences between the blood flow parameters of the mature follicle wall within 2 mm and the dominant ovarian blood flow parameters of the same group (P < 0.045), and the blood flow parameters of the corresponding parts of the control group were significantly different from those of the control group (respectively) (P < 0.05). The blood flow grade of mature follicles in the control group was 3-4 grade and 1-2 grade in LUFS group. Conclusion:. 1Ovarian reserve function in LUFS patients was similar to that in normal ovulation patients. 2. The blood perfusion parameters of the dominant ovaries and peridominant follicles in normal ovulation patients increased with the follicular development, suggesting that the normal mature follicles need abundant blood supply. (3) the blood flow in the periovulatory stage of the dominant ovary of LUFS patients was more abundant than that in the control group, but there were still obvious deficiencies. The number of blood vessels around the wall of the mature follicle was more than that of the whole ipsilateral ovary, but lower than that of the control group, and the number of neovaries was less. Low blood flow may be the characteristic of LUFS. 4. Transvaginal three-dimensional power Doppler ultrasound has a unique advantage in detecting ovarian blood perfusion. Three-dimensional transvaginal scanning in follicular phase is helpful for early identification of pathological follicle development and ovulation disorders.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.6;R445.1

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