Application of Multimodality Imaging Scoring in Evaluation of Endometrial Receptivity in Patients with Recurrent Spontaneous Abortion

doi:10.12114/j.issn.1007-9572.2019.00.711

Abstract

Abstract: Background　The effective evaluation of abnormal endometrial receptivity has important clinical value for the diagnosis and treatment of recurrent spontaneous abortion（RSA）.The quantitative evaluation of endometrial receptivity using multimodality imaging scoring might become a highly practical and feasible method facilitating，the diagnosis and treatment of RSA.Objective　To evaluate the value and feasibility of multimodality imaging scoring in the evaluation of endometrial receptivity in RSA patients.Methods　78 RSA patients（RSA group） and 80 women of childbearing age with delivery history and without spontaneous abortion history（control group） from Wenzhou People's Hospital were enrolled from January to December 2018.Intergroup comparisons were made in terms of mean age，BMI and hormone levels，and multimodality imaging score developed by additive summation of the evaluation scores of mid-luteal phase（7-9 days after ovulation） endometrial parameters（endometrial thickness，morphology type and movement examined by two-dimensional gray-scale ultrasound，endometrial-subendometrial blood flow distribution examined by two-dimensional color Doppler ultrasound，and endometrial volume and blood flow examined by three-dimensional ultrasound）.Results　Both groups had no significant differences in mean age，BMI，and levels of estradiol，progesterone，testosterone，luteinizing hormone，prolactin and follicle-stimulating hormone（P>0.05）.RSA group showed lower mean multimodality imaging score than the control group〔（10.3±2.8） vs（14.3±1.5），P<0.05〕.Conclusion　The multimodality imaging score is reduced in RSA patients.The multimodality imaging scoring，can be used to evaluate endometrial receptivity of RSA effectively.This method can minimize the differences in subjective judgments made by different operators，which is more objective and has important clinical application value.

Key words: Endometrial receptivity；Abortion, spontaneous；Ultrasonography；Ultrasonic multimode；Quantitative scores

摘要： 背景　子宫内膜容受性异常的有效评价对于复发性自然流产（RSA）的诊治具有重要的临床价值，子宫内膜容受性的超声多模态量化评估很有可能成为一种实用性强、可行性高的方法，从而利于该类患者的诊断和治疗。目的　对RSA患者进行超声检查，探讨超声多模态评分在RSA患者子宫内膜容受性评价中的应用价值及可行性。方法　选取2018年1—12月于温州市人民医院就诊的RSA患者78例为RSA组，选取同期在本院就诊的已生育且既往无自然流产病史的育龄期妇女80例为正常对照组。收集两组受试者的年龄、体质指数，检测激素水平。两组受试者均应用二维灰阶超声、二维彩色多普勒超声、三维超声等多种模式对黄体中期（排卵后7~9 d）子宫内膜进行检查，对受试者的子宫内膜厚度、内膜类型、内膜运动、内膜及内膜下血流分布、内膜体积和内膜血管血流指数等进行评分获得子宫内膜超声多模态评分，并进行对比分析。结果　两组受试者的年龄、体质指数、雌二醇、孕酮、睾酮、促黄体生成素、催乳素和促卵泡生成激素比较，差异均无统计学意义（P>0.05）。RSA组子宫内膜超声多模态评分为（10.3±2.8）分，低于正常对照组的（14.3±1.5）分（P<0.05）。结论　RSA患者子宫内膜超声多模态评分较正常者降低，通过超声多模态评分可对RSA患者子宫内膜容受性进行有效评价，且该评分方法能够减少由不同操作者间主观判断不同造成的差异，更为客观，具有重要的临床应用价值。

关键词: 子宫内膜容受性；流产, 自然；超声检查；超声多模态；量化评分

JIAO Yan,SHUI Xujuan,YU Caicha, et al. Application of Multimodality Imaging Scoring in Evaluation of Endometrial Receptivity in Patients with Recurrent Spontaneous Abortion　[J]. Chinese General Practice, 2020, 23(3): 299-304. DOI: 10.12114/j.issn.1007-9572.2019.00.711.
焦岩,水旭娟,余彩茶等. 超声多模态评分在复发性自然流产患者子宫内膜容受性评价中的应用研究[J]. 中国全科医学, 2020, 23(3): 299-304. DOI: 10.12114/j.issn.1007-9572.2019.00.711.

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