Center for Reproductive Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
J Ultrasound Med. 2013 Feb;32(2):247-55. doi: 10.7863/jum.2013.32.2.247.
To investigate whether the endometrial thickness, endometrial volume, and endometrial and subendometrial vascularization index, flow index, and vascularization-flow index were useful for diagnosing endometrial polyps in infertility.
Transvaginal and 3-dimesional power Doppler sonography was performed to calculate the endometrial echogenicity, endometrial thickness, endometrial volume, and endometrial and subendometrial vascularization index, flow index, and vascularization-flow index, followed by hysteroscopy in the follicular phase of the menstrual cycle (postmenstrual days 3-7). A total of 555 patients were selected, and 4 groups were defined according to the comparison of sonographic and hysteroscopic diagnoses: group A (sonographically positive but hysteroscopically negative), group B (sonographically and hysteroscopically negative), group C (sonographically negative but hysteroscopically positive), and group D (sonographically and hysteroscopically positive).
A total of 426 patients were enrolled in the final analysis. Significantly higher endometrial thickness and volume were found in groups C and D compared with groups A and B (P < .05). There were no significant differences among the 4 groups in terms of the endometrial and subendometrial vascularization index, flow index, and vascularization-flow index (P > .05). The sensitivity, specificity, and positive and negative predictive values of endometrial thickness and volume in predicting endometrial polyps were 62.7%, 69.8%, 26.9%, and 91.9% and 39.3%, 88.2%, 35.8%, and 89.7%, respectively. Combined sonographic evaluation (sonographic echogenicity, endometrial thickness, and endometrial volume) showed higher sensitivity, specificity, and positive and negative predictive values (65.6%, 89.0%, 50.0%, and 93.9%) compared with a single indicator.
A combination of endometrial echogenicity, thickness, and volume on sonography may be better than a single indicator for predicting endometrial polyps in infertility. However, the endometrial or subendometrial vascularization index, flow index, and vascularization-flow index are not useful for prediction.
探讨子宫内膜厚度、体积以及子宫内膜和内膜下血流灌注指数、血流指数和血流灌注指数是否有助于诊断不孕患者的子宫内膜息肉。
经阴道和三维能量多普勒超声检查计算子宫内膜回声强度、子宫内膜厚度、子宫内膜体积以及子宫内膜和内膜下血流灌注指数、血流指数和血流灌注指数，然后在月经周期卵泡期（月经后第 3-7 天）行宫腔镜检查。共选择 555 例患者，根据超声和宫腔镜诊断比较将其分为 4 组：A 组（超声阳性而宫腔镜阴性）、B 组（超声和宫腔镜均阴性）、C 组（超声阴性而宫腔镜阳性）和 D 组（超声和宫腔镜均阳性）。
共纳入 426 例患者进行最终分析。与 A 组和 B 组相比，C 组和 D 组的子宫内膜厚度和体积明显更大（P＜0.05）。4 组患者的子宫内膜和内膜下血流灌注指数、血流指数和血流灌注指数无显著差异（P＞0.05）。子宫内膜厚度和体积预测子宫内膜息肉的敏感性、特异性、阳性预测值和阴性预测值分别为 62.7%、69.8%、26.9%和 91.9%和 39.3%、88.2%、35.8%和 89.7%。与单一指标相比，超声联合评估（超声回声强度、子宫内膜厚度和子宫内膜体积）具有更高的敏感性、特异性和阳性预测值（65.6%、89.0%、50.0%和 93.9%）。
与单一指标相比，超声检查子宫内膜回声强度、厚度和体积的联合评估可能更有助于预测不孕患者的子宫内膜息肉。然而，子宫内膜或内膜下血流灌注指数、血流指数和血流灌注指数对于预测并无帮助。
Zotero 插件