经阴道三维容积超声检查在多囊卵巢综合征患者诊断中的应用价值

The diagnosis value of transvaginal three-dimensional ultrasonography in polycystic ovary syndrome diagnosis

目的探讨经阴道三维容积超声检查在多囊卵巢综合征(PCOS)患者诊断中的应用价值。方法选取2014年6月至2016年6月首都医科大学附属北京妇产医院收治的PCOS患者75例(PCOS组),同时选取同期50名行孕前检查的孕妇作为健康对照组。应用虚拟器官计算机辅助分析(VOCAL)技术测量所有受检者子宫内膜及卵巢体积,同时应用三维超声自动卵泡容积测量(Sono follicle)技术计数卵泡并测量卵泡体积。采用独立样本t检验比较PCOS组患者与健康对照组受检者子宫内膜体积、卵巢体积、卵泡体积、平均卵泡个数差异;应用Pearson相关分析分析PCOS组患者总卵泡个数与卵巢体积、卵泡体积、血清性激素浓度的相关性。结果 PCOS组患者子宫内膜体积为(1.6±0.9)cm^3,小于健康对照组受检者的(3.1±1.7)cm^3,卵巢体积、卵泡体积、平均卵泡个数分别为(13.6±4.6)cm^3、(1.9±0.7)cm^3、(27.7±7.4)个,均高于健康对照组受检者的(7.4±2.9)cm^3、(1.1±0.7)cm^3、(8.4±3.4)个,且差异均有统计学意义(t=6.013,P<0.001;t=8.087,P=0.015;t=7.222,P<0.001;t=15.637,P<0.001)。PCOS患者总卵泡个数与卵巢体积、卵泡体积、血清睾酮浓度均呈正相关(r=0.467,P=0.000;r=0.446,P=0.000;r=0.383,P=0.001),与血清促黄体生成素浓度/卵泡雌激素浓度无相关性(r=0.048,P=0.702)。结论 Sono follicle及VOCAL技术为PCOS诊断提供了一种新的客观的测量方法。

ObjectiveTo investigate the diagnosis value of the three-dimensional transvaginal ultrasound volume technology in polycystic ovary syndrome （PCOS）. MethodsTotally 75 patients with PCOS and 50 normal subjects as controls from Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University were chosed. The volume of the endometrium and ovaries were measured with virtual organ computer-aided analysis techniques （VOCAL）. While the follicular numbers and the volumes were measured by sono follicle technique. The ovarian volumes, the follicular volumes and the endometrial volumes were compared between the two groups. Independent samples t test was used to compare PCOS group patients and healthy subjects with endometrial volumes, ovarian volumes, follicle volumes and the average numbers of follicle. Pearson correlation analysis was used to analyze the correlation between the number of total follicles and the volume of ovary, follicle volume and serum sex hormone concentration in PCOS group. ResultsWith the endometrial volume of PCOS patients about （1.6±0.9） cm3 was less than that of the control group [（3.1±1.7） cm3]. The ovarian volume, follicular volume and the average number of follicles were （13.6±4.6） cm3, （1.9±0.7） cm3 and （27.7±7.4）. All of them were higher than those in healthysubjects [（7.4±2.9） cm3, （1.1±0.7） cm3, （8.4±3.4）], and the differences were statistically signi？cant （t=6.013, P 〈 0.001; t=8.087, P=0.015; t=7.222, P 〈 0.001; t=15.637, P 〈 0.001）. The total number of follicles in PCOS patients were positively correlated with ovarian volume, follicle volume and serum testosterone concentrations （r=0.467, P=0.000; r=0.446, P=0.000; r=0.383, P=0.001）. There was no correlation with luteinizing hormone （LH）/thyroid stimulating hormone （TSH） （r=0.048, P=0.702）. ConclusionThe sono follicle and VOCAL technology provide a new and objective measurement method for PCOS diagnosis.