经阴道三维超声定量测量评估卵巢功能的初步研究

Preliminary study on evaluation of ovarian function by transvaginal three dimensional ultrasound quantitavive measurement

目的:探讨经阴道三维超声定量测量卵巢体积及血流灌注参数评估卵巢功能的可行性及临床价值。方法:34例临床拟诊卵巢早衰的患者,应用虚拟器官计算机辅助分析(VOCAL)和三维能量多普勒超声(3D-CPA)对全部患者卵巢进行定量测量,获得卵巢体积及卵巢基质血管化指数(VI)、血流指数(FI)、彩色强度总和(VFI)等指标。所有患者以实验室检测指标为金标准分为三组,FSH>40U/L,E2<73.2pmol为卵巢衰竭组;FSH介于10～40U/L之间,FSH/LH>3.6,E2<43.9pmol为卵巢储备功能下降组;FSH<1OU/L为正常组,进行统计分析。结果:卵巢的体积、VI、FI、VFI与FSH存在明显负相关(r分别为-0.521、-0.511、-0.817、-0.436,P<0.05)。三组间的卵巢体积、VI、FI和VFI等参数差异有统计学意义,正常组>下降组>衰竭组(P<0.05)。结论:经阴道三维超声对卵巢进行定量测量可以间接评估卵巢功能,为卵巢早衰的诊断提供有价值的信息。

Objective：To explore the feasibility and clinical value of ovarian volume and blood flow parameter in evaluating ovarian function by transvaginal three dimensional ultrasound quantitavive measurement.Methods：34 patients with clinically suspected premature ovarian failure（POF） were examined by virtual organ computer-aided analysis（VOCAL） and three dimensional color power angio（3D-CPA）.Volume,vascularzaion index（VI）,flow index（FI）,and vascularization-flow index（VFI） of ovarian were acquired.All the patients were divided into three groups with laboratory indexs as golden standard：premature ovarian failure（POF） group（FSH〉40 U/L and E2〈73.2 pmol）,decreasing ovarian store（DOS） group（l0 U/L〈FSH〈40 U/L,FSH/LH〉3.6 and E2〈43.9 pmol）,normal group（FSH〈10 U/L）,and statistical analysis was performed.Results：There was significant negative correlation between FSH and volume,VI,FI,and VFI of ovarian respectively（r=-0.521,r=-0.511,r=-0.817,r=-0.436,P〈0.05）.There were significant differences among these three groups in volume,VI,FI,and VFI of ovarian（normal group〉 DOS group 〉POF group,P〈0.05）.Conclusion：Transvaginal three dimensional ultrasound quantitavive measurement might be a new method to evaluate the ovarian function indirectly,and valuable information could be provided in the diagnosis of POF.