实时灰阶超声造影评价子宫内膜容受性的初步探讨

Assessment the value of perfusion characteristics of endometrium in the prediction of endometrial receptivity with real-time gray-scale contrast-enhanced ultrasound

目的用实时灰阶谐波超声造影及时间-强度曲线评价正常孕龄妇女分泌期子宫内膜的灌注情况,探讨其临床价值,为正确评估子宫内膜容受性提供理论依据。方法应用经阴道超声对28例(内膜呈三线型者16例,内膜呈非三线型者12例)健康孕龄妇女于分泌期观察子宫内膜厚度、回声类型,选用Sono Vue作为造影剂,通过实时造影匹配成像(Cn TI)技术超声造影,应用随机配置的造影剂声学定量时间-强度曲线分析软件,测量声学定量参数,对比分析2组子宫内膜及肌层的灌注情况,比较不同子宫内膜类型的内膜灌注特点。结果内膜为三线型者和内膜为非三线型者内膜的厚度差异无统计学意义(P>0.05);子宫内膜回声为三线型者峰值时间(TTP),明显较非三线型者提前,差异有统计学意义(P<0.05);子宫内膜回声为三线型者峰值强度(PI)明显低于非三线型者,差异有统计学意义(P<0.05);所有受试者肌层达峰时间较内膜提前,而峰值强度均高于内膜,差异有统计学意义(P<0.05)。结论经阴道超声检测子宫内膜回声类型结合超声造影内膜血流灌注特点,可为临床评价子宫内膜的微血管灌注情况提供更好的诊断线索,可以成为评估子宫内膜容受性的参考指标之一。

Objective To investigate the perfusion characteristics of endometrium with real-time gray-scale contrast ultrasound and time-intensity curve software in women, to Assess the clinic value and provide theory basis for the prediction of endometrial receptivity. Methods Twenty-eight women （16 triplelined endometrium,12 non-triple- lined endometrium） undergoing secretive phase were reeruited.Transvaginal uhrasound examination was performed to determine and compare endometrial thickness,endometrial pattern,SonoVue and CnTI Techs were used in the exami- nation. To measure acoustic quantified parameters and compares and analyses the perfusion characteristics of en- dometrium and the wall of uterus, in different groups. Results There was no significant differencebetween the group with triplelined endometrium and the group with non-triplelined endometrium in endometrial thickness （P〉0.05）. The time-to-peak-intensity was significantly shorter in the group with triplelined endometrium than the group with non- triplelined endometrium （P〈0.05）. The peak-intensity was significantly higher in the group with non-triplelined en- dometrium than the group with triplelined endometrium （P〈0.05）. The time-to-peak-intensity was significantly shorter in uterus muscle than in endometrium （P〈0.05）, The peak-intensity was significantly higher uterus muscle than in endometrium. Conclusion Endometrial pattern and perfusion characteristics of endometrium measured with transvaginal ultrasound can be a better diagnosis clue in evaluating perfusion of microvascular and can be as reli- able indicators to assess endometrial receptivity.