Comparison Of The Value Of Corpus Luteum Blood Flow In Early Pregnancy By Transvaginal Two-dimensional And Three-dimensional Ultrasound

Objective:There is a certain correlation between luteal blood flow and pregnancy outcome.However,there is still a lack of systematic research to determine the quantitative relationship,especially in recent years,the emergence of transvaginal three-dimensional power Doppler ultrasound,and the lack of its advantages and disadvantages compared with two-dimensional ultrasound.Therefore,this study compared the predictive value of transvaginal two-dimensional ultrasound and three-dimensional power Doppler ultrasound in detecting luteal blood flow in early pregnancy.Methods:194 subjects of early pregnancy were selected as the study subjects.The pregnant women were divided into normal pregnancy group(n = 223)and termination pregnancy group(n = 41).According to the outpatient and inpatient medical record system and related examinations,the demographic characteristics,marriage,childbirth and menstrual history of the subjects were collected.All the subjects were examined by transvaginal two-dimensional ultrasound and three-dimensional power Doppler ultrasound,and collected the relevant parameters,such as diameter(D),resistance index(R),pulsatility index(PI),volume(V),angiogenesis index(VI),flow index(FI),blood flow index(FI)Vascular flow index(VFI).Among them,the V,VI,FI and VFI of three-dimensional power Doppler ultrasound to detect corpus luteum parameters are calculated by virtual organ computer aid analysis(VOCAL)software.All data in this study were analyzed by SPSS 22.0 software.The receiver operating characteristic curve(ROC)was used to evaluate the ability of different ultrasound parameters to predict the outcome of pregnancy,the area under the curve(AUC)of each ROC curve was calculated,and the difference of different AUC was compared by Delong test.Results: 1.According to the inclusion criteria and exclusion criteria of the study,194 subjects were finally included.According to the pregnancy outcome at 12 weeks of gestation,163 cases were divided into normal pregnancy group and 31 cases in termination pregnancy group.There was no significant difference in age,pregnancy,pregnancy times,smoking history,drinking history and BMI between the two groups.The baseline data of termination pregnancy group and normal pregnancy group were comparable.2.In the measurement of luteal parameters by transvaginal two-dimensional ultrasound: the average D value of luteal parameters in the normal pregnancy group(21.17 ± 3.30 mm)was significantly higher than that in the termination pregnancy group(13.87 ± 2.91 mm).The average RI of the normal pregnancy group was 0.51 ± 0.17,which was significantly lower than that of the termination group(0.58 ± 0.21);the average PI of the normal pregnancy group was 0.69 ± 0.18,which was significantly lower than that of the termination group(0.87 ± 0.13).The difference was statistically significant(P < 0.05).3.In the three-dimensional transvaginal ultrasound measurement of corpus luteum parameters,the V value of the normal pregnancy group was 6.57 ± 2.03 mm3,which was significantly higher than that of the termination pregnancy group(3.70 ± 1.58 mm3).The VI of luteum in normal pregnancy group was 25.79 ± 10.97,which was significantly higher than that in termination pregnancy group(16.25 ± 6.31).The FI of corpus luteum in normal pregnancy group was 47.22 ± 22.38,which was significantly higher than that in termination pregnancy group(30.92 ± 5.97).The VFI of normal pregnancy group was 13.88 ± 3.51,which was significantly higher than that of termination pregnancy group(7.01 ± 3.64,P = 0.000).4.The best diagnostic cut-off points for predicting the outcome of early intrauterine pregnancy were D: 14.48,RI: 0.56,PI: 0.81,V: 3.89,VI: 21.48,FI: 38.99,VFI: 10.21.The sensitivity and specificity were D(99.2%,67.0%),RI(98.9%,65.0%),PI(78.4%,89.1%),V(95.1%,78.4%),VI(74.0%,90.9%),FI(91.8%,90.9%)and VFI(93.9%,87.5%).5.The area under curve(AUC)of the combined index(RI + FI)in predicting the outcome of early intrauterine pregnancy was 0.963,which was not significantly different from the parameters of RI(AUC = 0.969)and FI(AUC = 0.964)(P > 0.05).Conclusion: 1.RI and FI of normal pregnancy group were significantly lower than those of termination pregnancy group,while D,V,VI,FI and VFI were significantly higher than those of termination pregnancy group.2.RI in transvaginal two-dimensional ultrasound and FI in three-dimensional ultrasound have high predictive value for the outcome of early pregnancy.3.The combined index of RI and FI is not better than that of RI or FI alone in predicting the outcome of early intrauterine pregnancy.