Wang Wei-Qiang, Chu Guang-Hua, Hou Xiao-Xia
Department of Gynecology II, Northwest Women's and Children's Hospital, Xi'an, China.
Medical Ultrasound Center, Northwest Women's and Children's Hospital, Xi'an, China.
Ann Transl Med. 2023 Jan 31;11(2):110. doi: 10.21037/atm-22-5813.
Doppler ultrasonography is used to study ovarian vascular characteristics. However, the outcomes are reported with a considerable variability in literature. Here we review the differences in Doppler ultrasound-measured ovarian blood flow indices between women with and without ovarian dysfunction and seeks correlations between Doppler measures and ovarian markers.
A literature search was conducted in electronic databases (Google Scholar, Ovid, PubMed, Science Direct, and Springer) to identify studies that used Doppler for ovarian blood flow examination and reported Doppler measures in women with and without ovarian dysfunction and/or the correlations between wDoppler indices and markers of ovarian dysfunction. After quality assessment of included studies, a meta-analysis of weighted mean differences (WMDs) between women with and without ovarian dysfunction in vascularization index (VI), flow index (FI), vascularization flow index (VFI), pulsatility index (PI) and resistance index (RI) was performed. Correlation coefficients between Doppler indices and markers of ovarian dysfunction were pooled to achieve overall estimates.
A total of 27 studies [2,377 women with ovarian dysfunction and 308 controls; age 27.7 years, 95% confidence interval (CI): 26.4 to 29.1] were included. These studies were of moderate quality. The VI (WMD 9.75; P<0.0001), FI (WMD 2.73; P<0.0001), and VFI (WMD 1.29; P<0.0001) were significantly higher whereas PI (WMD -1.08; P=0.001) and RI (WMD -0.26; P<0.0001) were significantly lower in women with polycystic ovarian syndrome (PCOS) than in normal women. In women undergoing fertilization (IVF)/intracytoplasmic sperm injection (ICSI), antral follicle count was positively correlated with VI (r=0.24; P=0.001), FI (r=0.42; P<0.0001), and VFI (r=0.25; P=0.002). In women with PCOS, testosterone had statistically non-significant correlations with VI (r=0.40; P=0.081), and VFI (r=0.39; P=0.063) and was inversely correlated with PI (r=-0.30; P<0.0001) and RI (r=-0.48; P<0.0001). In women with PCOS, luteinizing hormone (LH) was inversely correlated with PI (r=-0.26; P=0.086) and RI (r=-0.25; P=0.007).
Doppler indices are found significantly different in women with and without ovarian dysfunction and have significant correlations with markers of ovarian dysfunction. These results support the use of Doppler ultrasound to examine ovarian dysfunction. High statistical heterogeneity observed herein should be studies in future investigations.
多普勒超声用于研究卵巢血管特征。然而，文献报道的结果存在相当大的差异。在此，我们回顾有无卵巢功能障碍女性之间多普勒超声测量的卵巢血流指数差异，并探寻多普勒测量值与卵巢标志物之间的相关性。
在电子数据库（谷歌学术、Ovid、PubMed、科学Direct和Springer）中进行文献检索，以识别使用多普勒进行卵巢血流检查并报告有无卵巢功能障碍女性的多普勒测量值和/或多普勒指数与卵巢功能障碍标志物之间相关性的研究。在对纳入研究进行质量评估后，对有无卵巢功能障碍女性在血管化指数（VI）、血流指数（FI）、血管化血流指数（VFI）、搏动指数（PI）和阻力指数（RI）方面的加权平均差异（WMD）进行荟萃分析。汇总多普勒指数与卵巢功能障碍标志物之间的相关系数以获得总体估计值。
共纳入27项研究[2377例卵巢功能障碍女性和308例对照；年龄27.7岁，95%置信区间（CI）：26.4至29.1]。这些研究质量中等。多囊卵巢综合征（PCOS）女性的VI（WMD 9.75；P<0.0001）、FI（WMD 2.73；P<0.0001）和VFI（WMD 1.29；P<0.0001）显著高于正常女性，而PI（WMD -1.08；P=0.001）和RI（WMD -0.26；P<0.0001）显著低于正常女性。在接受体外受精（IVF）/卵胞浆内单精子注射（ICSI）的女性中，窦卵泡计数与VI（r=0.24；P=0.001）、FI（r=0.42；P<0.0001）和VFI（r=0.25；P=0.002）呈正相关。在PCOS女性中，睾酮与VI（r=0.40；P=0.081）和VFI（r=0.39；P=0.063）的相关性无统计学意义，与PI（r=-0.30；P<0.0001）和RI（r=-0.48；P<0.0001）呈负相关。在PCOS女性中，黄体生成素（LH）与PI（r=-0.26；P=0.086）和RI（r=-0.25；P=0.007）呈负相关。
有无卵巢功能障碍女性的多普勒指数存在显著差异，且与卵巢功能障碍标志物有显著相关性。这些结果支持使用多普勒超声检查卵巢功能障碍。本文观察到的高统计学异质性应在未来研究中进一步探讨。
