三维能量多普勒检测体外授精-胚胎移植患者子宫内膜血流参数与妊娠结局的关系

目的 探讨体外授精-胚胎移植患者子宫动脉血流和子宫内膜血流参数与妊娠结局的关系.方法 行体外授精-胚胎移植的不孕症患者90例,均于注射绒毛膜促性腺激素(HCG)日应用三维能量多普勒超声测量子宫内膜厚度、内膜容积以及内膜血流参数.根据其妊娠与否分为妊娠组(43例,包括生化妊娠和临床妊娠)和非妊娠组(47例),比较两组之间参数的差异.结果 两组间子宫动脉搏动指数(PI)、阻力指数(RI)值及内膜体积比较差异无统计学意义(P＞0.05)；内膜血管指数(VI)、血流指数(FI)和血管-血流指数(VFI)比较差异有统计学意义(P＜0.05).VI、FI、VFI的曲线下面积分别为0.880、0.713和0.646.其中VI的曲线下面积最大,VI的截断值为0.733％时,敏感性为84.2％,特异性为88.9％.结论 在注射HCG日经阴道三维能量多普勒测量子宫内膜血流参数能较好地评价子宫内膜血流,预测妊娠结局.

Relationship between endometrial blood flow measured by three-dimensional power Doppler ultrasound and pregnancy for women who received the treatment of in vitro fertilization and embryo transfer

Objective To evaluate whether endometrial blood flow measured by three-dimensional power Doppler ultrasound can predict pregnacy after the treatment of in vitro fertilization and embryo transfer (IVF-ET).Methods Ninty women who received the treatment of IVF-ET examined by threedimensional power Doppler imaging at the day of inject human chorionic gonadotropin(HCG) were enrolled.All patients were divided into pregnancy group (43 cases,include biochemical pregnancy and clinical pregnancy ) and non-pregnancy group(47 cases).The diagnostic value of parameters derived from threedimensional power Doppler imaging was evaluated by using the receiver operating characteristic (ROC)curve.Results Differences of these parameters,including vascularization index (VI),flow index(Fl) and vascularization flow index (VFI) were considered statistically significant between two groups,the parameters of uterine artery and endometrial volume had no significant differences between two groups.The area under ROC curve of VI,FI and VFI were 0.880,0.713 and 0.646,respectively.Among these parameters,VI had the highest diagnostic value for discriminating between benign and malignant endometrium,the cut-off value of which was 0.733 with a sensitivity of 84.2％.Conclusions Threedimensional power Doppler ultrasound was useful for evaluating endometrial blood flow in IVF-ET cycles.Endometrial blood flow parameters may be useful predictors for pregnancy.