3D-PDI相关参数对体外受精-胚胎移植妊娠结局的预测价值

Predictive value of 3D-PDI parameters for pregnancy outcomes after in vitro fertilizationembryo transfer

目的:分析三维能量多普勒血流显像超声(3D-PDI)相关参数对体外受精-胚胎移植(IVF-ET)妊娠结局的预测价值。方法:以2021年12月~2022年3月收治的IVF-ET助孕患者100例为研究对象,所有患者均进行IVF-ET助孕,后进行3D-PDI检查。根据患者IVF-ET后14 d孕酮水平将其分为孕酮升高组(34例)和孕酮正常组(66例),比较两组3D-PDI检查的相关参数;根据患者是否成功妊娠将患者分为妊娠组(47例)和未妊娠组(53例),比较两组3D-PDI检查的相关参数。绘制受试者工作特征(ROC)曲线获取曲线下面积(AUC),分析3D-PDI检查的相关参数单独及联合对IVF-ET助孕患者妊娠结局的预测价值。结果:孕酮升高组子宫内膜回声分型A型、B型及内膜血流分型Ⅱ型、Ⅲ型患者占比(20.59%、32.35%和20.59%、14.71%)低于孕酮正常组(33.33%、42.42%和37.88%、30.30%)(P<0.05),子宫内膜回声分型C型及内膜血流分型Ⅰ型患者占比(47.06%和64.71%)高于孕酮正常组(24.24%和31.82%)(P<0.05);孕酮升高组内膜厚度、容积、血管化指数(VI)、血管化血流指数(VFI)、血流指数(FI)均低于孕酮正常组(P<0.05)。妊娠组内膜容积、VI、VFI、FI高于未妊娠组(P<0.05)。ROC曲线分析结果显示内膜容积、VI、VFI、FI联合对预测IVF-ET助孕患者妊娠结局AUC及敏感度均高于其单独预测(P<0.05)。结论:IVF-ET助孕患者内膜容积、VI、VFI、FI升高有助于患者成功妊娠,同时4者联合对IVF-ET助孕患者妊娠结局具有良好的预测价值。

Objective To analyze the value of three-dimensional power Doppler imaging(3D-PDI)parameters to predict the pregnancy outcomes after in vitro fertilization-embryo transfer(IVF-ET).Methods A total of 100 patients treated with IVF-ET from December 2021 to March 2022 were enrolled.All patients underwent IVF-ET followed by 3D-PDI.According to the progesterone level on day 14 after IVF-ET,the patients were divided into progesterone elevation group(n=34)and normal progesterone group(n=66),and the relevant parameters of 3D-PDI were compared between the two groups.According to whether the pregnancy was successful or not,the patients were divided into pregnant group(n=47)and nonpregnant group(n=53),and the relevant parameters of 3D-PDI were compared between the two groups.The area under the receiver operating characteristic curve(AUC)was used to analyze the predictive value of 3D-PDI parameters alone and in combination for pregnancy outcomes after IVF-ET.Results The proportions of endometrial echo types A and B and endometrial blood flow typesⅡandⅢin progesterone elevation group were 20.59%,32.35%,20.59%,14.71%,respectively,lower than those in normal progesterone group(33.33%,42.42%,37.88%,30.30%,respectively)(P<0.05).The endometrial echo type C and endometrial blood flow typeⅠwere observed in 47.06%and 64.71%of patients in progesterone elevation group,and in 24.24%and 31.82%of patients in normal progesterone group(P<0.05).Progesterone elevation group had lower intimal thickness,volume,vascularization index(VI),vascularization flow index(VFI)and blood flow index(FI)than normal progesterone group(P<0.05).The endometrial volume,VI,VFI and FI of pregnant group were higher than those of non-pregnant group(P<0.05).Compared with parameter alone,the combination of endometrial volume,VI,VFI and FI had higher AUC and sensitivity for predicting pregnancy outcome after IVF-ET(P<0.05).Conclusion The increase of intimal volume,VI,VFI and FI in IVF-ET patients is helpful to the successful pregnancy,and their combination has a high predictive value for the pregnancy outcome after IVF-ET.