Mahmutyazicioğlu Kamran, Tanriverdi H Alper, Ozdemir Hüseyin, Barut Aykut, Davşanci Halit, Gündoğdu Sadi
Department of Radiology, Faculty of Medicine, Zonguldak Karaelmas University, Kozlu 67600, Zonguldak, Turkey.
Eur J Radiol. 2005 Feb;53(2):280-6. doi: 10.1016/j.ejrad.2004.03.024.
In virgin policystic ovary syndrome (PCOS) patients transabdominal sonography is the preferential method of the pelvic examination. The purpose of this study was to determine ovarian morphology by the transabdominal route by pulse inversion harmonic imaging (PIHI) in virgin PCOS patients and to compare the diagnostic image quality with conventional B-mode ultrasonography (CBU).
Fifty-two ovaries in 26 virgin patients were evaluated by the transabdominal approach. Each ovary was examined using both PIHI and CBU. The sharpness of the follicular cysts walls, degree of internal echo definitions of the follicle cysts and overall ovarian conspicuity was assessed subjectively, using 4 point scoring (0, being worst; 3, being best score). The number of countable follicles, the size of largest and smallest ovarian follicle and ovarian volumes were assessed quantitively by both techniques. The effect of body mass index (BMI) on qualitative and quantitative scoring was evaluated.
The sharpness of the cyst wall and internal echo structure was significantly better with PIHI than with CBU (P < 0.001 P < 0.001 and P < 0.001, respectively). PIHI improved overall ovarian conspicuity in 41 (78.8%) of 52 examination. The number of countable follicles was significantly lower with CBU (P < 0.001). The maximum diameter of the largest follicle was larger with PIHI sonography to compared CBU (P < 0.001). Mean ovarian volume was significantly larger with CBU (P < 0.001). When data were analyzed separately according to BMI, number of non-diagnostic overall ovarian conspicuity scores with CBU was markedly high in obese patients (88% with CBU versus 3.8% with PIHI). On the other hand, mean number of countable follicles with CBU became much more lower in the obese group (P < 0.001).
In virgin PCOS patients, when compared to transabdominal CBU, PIHI significantly improved the detection of ovarian follicles, especially in high BMI obese subjects, through increased contrast sensitivity for cystic structures and decreased intrafollicular artifactual echoes. Transabdominal ultrasonographic examination by PIHI mode can contribute to the evaluation of ovaries.
在初潮多囊卵巢综合征（PCOS）患者中，经腹超声检查是盆腔检查的首选方法。本研究的目的是通过经腹途径使用脉冲反转谐波成像（PIHI）确定初潮PCOS患者的卵巢形态，并将诊断图像质量与传统B型超声（CBU）进行比较。
对26例初潮患者的52个卵巢进行经腹评估。每个卵巢均使用PIHI和CBU进行检查。使用4分评分法（0分为最差；3分为最佳）主观评估卵泡囊肿壁的清晰度、卵泡囊肿内部回声清晰度以及整体卵巢清晰度。两种技术均定量评估可计数卵泡的数量、最大和最小卵巢卵泡的大小以及卵巢体积。评估体重指数（BMI）对定性和定量评分的影响。
PIHI检查时囊肿壁的清晰度和内部回声结构明显优于CBU（分别为P<0.001、P<0.001和P<0.）。在52次检查中，PIHI改善了41次（78.8%）的整体卵巢清晰度。CBU检查时可计数卵泡的数量明显较少（P<0.001）。与CBU相比，PIHI超声检查时最大卵泡的最大直径更大（P<0.001）。CBU检查时平均卵巢体积明显更大（P<0.001）。根据BMI分别分析数据时，肥胖患者中CBU检查时非诊断性整体卵巢清晰度评分的数量明显较高（CBU为88%，而PIHI为3.8%）。另一方面，肥胖组中CBU检查时可计数卵泡的平均数量更低（P<0.001）。
在初潮PCOS患者中，与经腹CBU相比，PIHI通过提高对囊性结构的对比敏感度和减少卵泡内伪像回声，显著改善了卵巢卵泡的检测，尤其是在高BMI肥胖受试者中。PIHI模式的经腹超声检查有助于卵巢评估。
