Application Analysis of Ultrasonic Evaluation in the Determination of Endometrial Receptivity
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摘要:
目的 探讨经阴道三维超声在子宫内膜容受性判定中的应用价值。 方法 回顾性选取昆明市妇幼保健院2022 年4 月至2023 年6 月106 例拟行辅助生殖者,所有辅助生殖者在妊娠前均接受经阴道三维超声检测,根据临床妊娠与否分为妊娠组(n = 48)和未妊娠组(n = 58 ),运用经阴道三维容积探头,记录2 组子宫内膜类型、子宫内膜血流分型、子宫内膜容积、妊娠率、子宫内膜及内膜下血流参数[血流指数(flow index,FI)、血管化指数(vascularization index,VI)、及血管-血流指数(vascular fiow index,VFI)]情况。 结果 2 组在子宫内膜类型、子宫内膜血流分型、子宫内膜容积方面比较,差异有统计学意义(P < 0.05);子宫内膜形态A型妊娠率高于C型,子宫内膜血流分型Ⅲ级妊娠率高于型Ⅰ级,差异有统计学意义(P < 0.05);2组在子宫内膜及内膜下FI、VI以及VFI方面比较,差异有统计学意义(P < 0.05)。 结论 经阴道三维超声技术能够有效评估子宫内膜容受性,预测妊娠结局,为临床治疗方案提供重要依据。 Abstract:Objective To investigate the application value of transvaginal three-dimensional ultrasound in the determination of endometrial receptivity. Methods A retrospective study was conducted on 106 patients who were scheduled to undergo assisted reproductive treatment at Kunming Maternal and Child Health Hospital from April 2022 to June 2023. All patients underwent transvaginal three-dimensional ultrasound examination before pregnancy. They were divided into a pregnant group (n = 48) and a non-pregnant group (n = 58) based on whether they achieved clinical pregnancy. The transvaginal three-dimensional volume probe was used to record the endometrial type, endometrial blood flow classification, endometrial volume, pregnancy rate, and endometrial and subendometrial blood flow parameters [Flow Index (FI), Vascularization Index (VI), and Vascular Flow Index (VFI)]. Results When comparing the endometrial type, endometrial blood flow classification, and endometrial volume between the two groups, statistically significant differences were observed (P < 0.05). The pregnancy rate of endometrial morphology type A was higher than that of type C, and the pregnancy rate of endometrial blood flow classification III was higher than that of type I, with statistically significant differences (P < 0.05). There were statistically significant differences in endometrial and subendometrial FI, VI and VFI between the two groups (P < 0.05). Conclusion Transvaginal three-dimensional ultrasound technology not only enables effective evaluation of endometrial receptivity, accurate prediction of pregnancy outcomes, but also provides an important basis for clinical treatment plans. -
表 1 2组一般资料比较[($\bar x \pm s $)/n(%)]
Table 1. Comparison of general data between the two groups[($\bar x \pm s $)/n(%)]
组别 n 平均年龄(岁) BMI(kg/m2) 不孕类型 原发性不孕 继发性不孕 不明原因不孕 妊娠组 48 30.7±6.1 21.65±2.56 33(68.75) 13(27.08) 2(4.17) 未妊娠组 58 32.5±5.6 22.07±2.35 41(70.69%) 14(24.14) 3(5.17) t/χ2 / 1.387 1.194 1.176 P / 0.170 0.235 0.915 表 2 2 组子宫内膜类型、血流分型分布及容积情况比较[($\bar x \pm s $)/n(%)]
Table 2. Comparison of endometrial types,blood flow classification distribution and volume between the two groups[($\bar x \pm s $)/n(%)]
组别 n 子宫内膜类型 子宫内膜血流分型 子宫内膜容积(mL) A型 B型 C型 Ⅰ级 Ⅱ级 Ⅲ级 妊娠组 48 28(58.33) 11(22.92) 9(18.75) 5(10.42) 14(29.17) 29(60.42) 3.52±1.31 未妊娠组 58 19(32.76) 18(31.03) 21(36.21) 27(46.55) 16(27.59) 15(25.86) 0.86±1.12 χ2/t / 6.265 6.457 4.962 P / 0.043* 0.039* 0.001* *P < 0.05。 表 3 2 组子宫内膜及内膜下血流的血流参数和血管化程度比较($\bar x \pm s $)(1)
Table 3. Comparison of blood flow parameters and degree of vascularization of endometrial and subendometrial blood flow between the two groups($\bar x \pm s $)(1)
组别 n 子宫内膜 VI FI VFI 妊娠组 48 22.41±3.12 32.15±2.63 6.59±1.09 未妊娠组 58 16.54±2.56 28.66±2.60 4.89±0.88 t / 6.973 4.475 4.254 P / 0.001* 0.001* 0.001* *P < 0.05。 表 3 2 组子宫内膜及内膜下血流的血流参数和血管化程度比较($\bar x \pm s $)(2)
Table 3. Comparison of blood flow parameters and degree of vascularization of endometrial and subendometrial blood flow between the two groups($\bar x \pm s $)(2)
组别 n 子宫内膜下 VI FI VFI 妊娠组 48 44.23±3.79 33.27±3.07 15.62±2.27 未妊娠组 58 36.15±3.55 30.79±3.17 11.16±2.07 t / 7.606 3.573 7.552 P / 0.001* 0.001* 0.001* *P < 0.05。 -
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