Hope Joanie Mayer, Long Kara, Kudla Marek, Arslan Alan, Tsymbal Tatiana, Strok Irina, Timor-Tritsch Ilan E
Department of Obstetrics and Gynecology, New York University Medical Center, 462 First Ave, New York, NY 11226, USA.
J Ultrasound Med. 2009 Aug;28(8):1043-52. doi: 10.7863/jum.2009.28.8.1043.
The purpose of this study was to assess the vascular indices generated by 3-dimensional (3D) power Doppler angiography by evaluating the cyclic changes in the vascularity of normal ovaries, including those that were ovulating, nonovulating, and hormonally suppressed.
In this prospective longitudinal observational study, a cohort of premenopausal regularly menstruating women with no known ovarian disease underwent 3D power Doppler imaging every 2 to 3 days for the duration of 1 menstrual cycle. Four indices were generated: vascularization index (VI), flow index (FI), vascularization-flow index (VFI), and mean grayness. Comparisons of vascularity were made between ovulating, nonovulating, and hormonally suppressed ovaries. Normal ranges were established and graphed longitudinally.
Eighteen participants (36 ovaries) ages 28 to 45 years underwent an average of 10 examinations, yielding 368 acquired ovarian volumes for analysis. Seven participants used hormonal contraception. The VI, FI, and VFI were closely correlated (Pearson product moment correlation coefficients, 0.52-0.95). The vascular indices of ovulating ovaries were significantly higher than those of nonovulating ovaries (VI, FI, and VFI, all P < .001), with the largest discrepancies during the luteal phase. Hormonally suppressed ovaries had significantly lower vascularity throughout the cycle (VI, P < .002; FI, P < .001; VFI, P < .007). The vascular indices of all groups appeared to drop during the late follicular period and then rise again.
The VI would suffice as the principal vascular parameter for 3D power Doppler analysis. Preovulatory scans may be more useful for distinguishing pathologic vascularization. Hormonally suppressed ovaries have significantly lower vascularity throughout the cycle. Normal-appearing ovaries with vascular indices above the normal ranges established by these data may warrant further investigation.
本研究的目的是通过评估正常卵巢血管生成的周期性变化，包括排卵、未排卵和激素抑制状态下的卵巢，来评估三维（3D）能量多普勒血管造影生成的血管指数。
在这项前瞻性纵向观察研究中，一组无已知卵巢疾病的绝经前规律月经妇女在1个月经周期内每2至3天接受一次3D能量多普勒成像。生成了四个指数：血管化指数（VI）、血流指数（FI）、血管化-血流指数（VFI）和平均灰度。对排卵、未排卵和激素抑制的卵巢的血管情况进行了比较。建立了正常范围并纵向绘制图表。
18名年龄在28至45岁的参与者（36个卵巢）平均接受了10次检查，共获得368个卵巢体积用于分析。7名参与者使用激素避孕。VI、FI和VFI密切相关（Pearson积矩相关系数，0.52 - 0.95）。排卵卵巢的血管指数显著高于未排卵卵巢（VI、FI和VFI，均P < .001），在黄体期差异最大。激素抑制的卵巢在整个周期中血管生成显著降低（VI，P < .002；FI，P < .001；VFI，P < .007）。所有组的血管指数在卵泡晚期似乎下降，然后再次上升。
VI足以作为3D能量多普勒分析的主要血管参数。排卵前扫描可能对区分病理性血管生成更有用。激素抑制的卵巢在整个周期中血管生成显著降低。血管指数高于这些数据确定的正常范围但外观正常的卵巢可能需要进一步检查。
