| ObjectiveTo determine basic ovarian status and ovarian blood flow characteristics quant if icationally in follicular phase in patients with Luteinized unruptured follicle syndrome using three-dimensional power Doppler ultrasound and Virtual Organ Computer-Aided Analysis(VOCAL)software.Methods1、A total of40infertile women with spontaneous regular menstrual cycles were enrolled in this Study.20cases of them were with Luteinized unruptured follicle syndrome, the rest of them who were in ovulation cycles in the corresponding periods as a normal control group.2、Data concerning age, height, weight, menstrual cycle length, duration of infertility were recorded.3、The level of based serum hormone were detected in the day4of the menstrual cycles. All patients underwent serial trans-vaginal3D ultrasound examinations of both ovaries on early-follicular phase (cycle day3to5), mid-follicular phase(diameters of the dominant follicles are between12-16mm)and in pre-ovulating phase (the day before ovulation). The volume and vascular indices of the ovaries, The shell with a diameter of2mm surrounding the dominant follicle were calculated off-line using VOCAL imaging program. SonoAVC was used to automatically measure the size and number of antral follicles. The endometrial thickness and echo patterns were recorded.4、Comparisons of indices were made between novulating group and Luteinized unruptured follicle syndrome group.Results 1、Endometrial thickness detected in the three follicular phase between the two group were no significant differences. There was finding that pattern B were more important endometrial echo in LUFS group in late follicular phase, while pattern A were the main endometrial echo in control group.2、There were no significant differences in the levels of based serum hormone between two groups, so as to the number of antral Follicles, ovarian volume, and vascular indices VI、FI、VFI in early-follicular phase.3、The Vascular indices in the dominant ovary increased during the follicular phase, there were significant differences between the three follicular phase(VI, FI, and VFI, all P=0.000). The vascular indices of ovulating ovaries were significantly higher than the contralateral nonovulating ovaries during the mid-follicular phase and pre-ovulating phase (VI, FI, and VFI, all P<0.01).4、FI in the dominant ovary in LUFS group manifested no unequivocal changes during the follicular phase(P=0.139),while VI and VFI significantly varied (P=0.004, P=0.008, respectively). In the mid-follicular phase and pre-ovulating phase VI、FI、VFI were significantly lower in LUFS group than in control group. Inside the dominant ovary, The shell with a diameter of2mm surrounding the dominant follicle had significantly higher average VI compared to the dominant ovary itself (P=0.045), and had significantly higher average VI、FI、VFI compared to the corresponding indices in control group(P=0.000, P=0.017, P=0.000, respectively). The amount of visible color flow around the dominant follicles were graded1to2in LUFS group, while in normal group were graded3to4.Conclusion1、There were no significant differences in ovarian reserve between the LUFS group and ovulating group.2、Vascular indices in the dominant ovary and dominant follicles increased during the follicular phase, which indicate mature follicles demand abundant blood supply.3、Blood supply in the dominant ovary of LUFS group increased in the late follicular phase, which were still significantly insufficient compared to the control group. And dominant follicles had a higher vascular indices than the whole dominant ovary in LUFS group, but still significantly lower than the ovulating group. Furthermore, the occurrence of LUF maybe be short of abundant blood supply, with reducing neovascularization and low blood flow around the dominant follicles.4、3D power Doppler is a new method of studying vascularization, there is potential for it to become a useful tool for studying pathological vascular changes associated with ovarian dysfunction and ovulation disorder. |
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