超声弹性成像诊断多囊卵巢综合征的价值探讨

Diagnostic value of ultrasound elastography in polycystic ovary syndrome

目的探讨超声弹性成像对多囊卵巢综合征(PCOS)的诊断价值。方法选取42例PCOS患者(PCOS组)和42例健康女性(对照组),于月经周期第7天测量卵巢体积、卵泡数、弹性成像模式及应变比值,比较两组间的差异。分析应变比值与卵巢体积和卵泡数间的相关性;绘制受试者工作特征(ROC)曲线分析卵泡数、卵巢体积及应变比值对PCOS的诊断效能。结果 PCOS组患者平均卵巢体积显著大于对照组[(12.9±3.8)cm^3vs.(5.6±1.7)cm^3];卵泡数显著多于对照组[(18.6±5.2)个vs.(8.5±2.6)个],差异均有统计学意义(均P<0.001)。PCOS组弹性成像模式以1型为主,对照组以3型为主,差异有统计学意义(P<0.001);PCOS组应变比值为8.4±1.6,对照组为4.5±1.2,差异有统计学意义(P<0.001)。以卵泡数≥12个诊断PCOS的敏感性85.4%、特异性89.5%、阳性预测值89.1%、阴性预测值86.0%,曲线下面积0.959;以卵巢体积≥10 cm3诊断PCOS的敏感性100%、特异性70.8%、阳性预测值77.4%、阴性预测值100%,曲线下面积0.962;以应变比值5.7诊断PCOS的敏感性88.1%、特异性83.3%,阳性预测值84.1%、阴性预测值87.5%、曲线下面积0.883。应变比值与卵巢体积和卵泡数均呈正相关(r=0.565、0.653,均P<0.001)。结论超声弹性成像在PCOS诊断中具有较好的临床应用价值。

Objective To explore the diagnostic value of ultrasound elastography in polycystic ovary syndrome (PCOS) .Methods Forty-two patients with PCOS( PCOS group) and 42 healthy women( control group) were enrolled in the study.Ovarian volume,number of follicles,elastic pattern and strain ratio were measured on the 7th day of the menstrual cycle, and the difference was compared between the two groups.Pearson correlation analysis was used to analyze the correlation between strain ratio,ovarian volume and follicle number.ROC curve was drawn to analyze the diagnostic effect of follicle number,ovarian volume and strain ratio on PCOS.Results The mean ovarian volume of PCOS group was significantly larger than that of the control group[( 12.9±3.8) cm3 vs.( 5.6±1.7) cm3,P<0.001] .Patients with PCOS showed more follicles than that of health control (18.6±5.2 vs. 8.5±2.6,P<0.001) .The dominant elasticity pattern of ovarian in PCOS group was type 1,whereas type 3 in the control group,the difference was statistically significant(P <0.001) .The mean strain ratios was higher in PCOS group when compared with control group( 8.4±1.6 vs. 4.5±1.2,P<0.001) .When the number of follicles was ≥12,the sensitivity of diagnosing PCOS was 85.4%,the specificity was 89.5%,the positive predictive value was 89.1%,and the negative predictive value was 86.0%,the area under the curve was 0.959.When the volume of ovary was ≥10 cm3,the sensitivity of diagnosing PCOS was 100%,the specificity was 70.8%,the positive predictive value was 77.4%,and the negative predictive value was 100%,the area under the curve was 0.962.Taken strain ratio was 5.7 as cutoff value,the sensitivity and specificity of diagnosing PCOS were 88.1% and 83.3%,respectively,the positive predictive value was 84.1%,the negative predictive value was 87.5%,and the area under the curve was 0.883.Strain ratio was positively correlated with the ovarian volume and the number of follicles,respectively (r=0.565,0.653,both P<0.001)C . onclusion Ultrasound elastography has a good clinical value in the diagnosis of PCOS.