| There was conflicting evidence regarding the effect of premenopausal hysterectomy with ovaries conserved on ovarian function. The previous literature mainly researched on the change of endocrine after hysterectomy and presumed the reason for the change may be reduced blood supply in ovary. More objective and visual methods were tried to detect the change of ovarian blood supply. The Color Doppler ultrasonography of ovarian artery more objectively and visually offered the characteristics , resistance and velocity of blood flow of ovarian artery which correlated closely with endocrine of gynecology . Therefore, the change of ovarian blood flow after hysterectomy can be studied by detecting the change of Doppler parameters of ovarian artery through the Color Doppler ultrasonography . No study has demonstrated the change of Doppler parameters of ovarian artery after hysterectomy. The objectives of this study were to evaluate the change of Doppler parameters of ovarian artery, the change of gynecology endocrine of maturity, perimenopause, postmenopause after hysterectomy with ovaries conserved. Thestudy also focused on whether there was consistency between Doppler parameters of ovarian artery and gynecology endocrine and whether the Doppler parameters of ovarian artery can reflect the function of endocrine , providing ultrasound evidence for clinic.Materials and methods1 Subjects: Thirty benign gynecologic patients (aged 34-50; mean?1SD;43.3 ?4.38years; regular menstrual cycles) who were undergone hysterectomy with ovaries conserved in our hospital from August 2000 to August 2002 were collected, measuring the Doppler parameters of ovarian artery peak systolic flow velocity(A), end diastolic flow velocity(B), resistance index(RI) and pulsed index(PI) ,while estradiol(E2), progesterone(P), testosterone(T), follicle stimulating hormone(FSH), luteinizing hormone(LH) and prolactin(PRL) detected by Elecsys 2010 instrument one day before hysterectomy operation ,on day 5 ,on day 30 and day 90 after operation. Thirty maturity patients(aged 22-34; mean±1SD 28.6± 2.93years; distributing proportionally on the phase of cycle) and thirty perimenopausal patients (aged 45-53; mean±SD 48.63±2.09; irregular menstrual cycle; uncertain phase of cycle) and thirty postpmenopausal patients(aged 56-80; mean±1SD 64.33 ± 6.45; years of menopause 4-30years; mean±SD 13.7± 7.2years)were selected by random to measure the 10 parameters(A; B; RI; PI; E2; P; T; FSH; LH; PRL).All the patients had not been treated with hormone prior to this study. 2 Equipments and methods The patients were assumed the lithotomy position and the probe was inserted into the posterior fornix of the vagina. Morphology of adnexa was explored by B mode sonography . Color Doppler enabled visualization of the ovarian artery blood flow at the lateral edge of the ovary. When the signal was not demonstrated clearly, the sample volume was moved across the ligament until the arterial signal was identified. Blood flow velocity waveforms wereobtained by positioning a sample to a colored spot and by activating the Pulsed Doppler. The record was considered satisfactory when there were at least five consecutive waveforms, each demonstrating the maximum Doppler shift. Signals from the ovarian artery were characterized by the low velocity and high impedance. Four Doppler parameters were calculated electronically from smooth curves fitted to the envelope of good quality waveforms over three cardiac cycles: the peak systolic flow velocity(A), end diastolic flow velocity(B), resistance index(RI) and pulsed index(PI).The equipment used was Acuson Color Doppler with a 5.0MHz transvaginal probe. The imaging, color Doppler, and pulsed Doppler frequencies were all 5.0MHz.The spatial peak temporal average intensity was <100mW/cm2 . A high pass filter of 125 Hz was used. The line of the pulsed Doppler beam was set to parallel to the vessel as could as possible .The angle between them was no bigger than 60 degrees.The sample volume was 1.5-2.5mm.Both ovaries wer... |
PDF Full Text Request