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目的探讨子宫内膜厚度、内膜下灌注参数与子宫内膜容受性的关系和MR灌注加权成像(PWI)评价子宫内膜容受性的价值。方法对22例不孕症(不孕组)及15名健康女性(对照组)分泌中期行MRI平扫及PWI,分别测量内膜厚度、内膜及内膜下灌注参数正性增强积分(PEI)、达峰时间(TTP)、平均强化时间(MTE)、最大增强线性斜率(MSI),比较两组各血流灌注参数间的差异。两组间内膜厚度及各灌注参数的比较采用两样本均数的t检验,内膜厚度与PEI间相关性分析采用Pearson法。结果不孕组与对照组内膜厚度之间差异具有显著统计学意义(t=6.54,P<0.01)。内膜两组灌注参数PEI、MSI、MTE值差异具有统计学意义(t=2.45、2.12、2.23,P<0.05),TTP值差异无统计学意义(t=1.25,P>0.05);内膜下两组各灌注参数值比较差异均无统计学意义(t=1.42、1.00、2.03、1.75,P>0.05)。子宫内膜厚度与PEI值进行回归分析,两者之间呈明显正相关(r=0.763,P<0.01)。结论 MR-PWI能够定量反映子宫内膜及内膜下的血流灌注状态,且内膜厚度与血容量之间存在一定相关性,对不孕患者子宫内膜容受性的评估有一定价值。
Objective To investigate the relationship between endometrial thickness, subintimal perfusion parameters and endometrial receptivity and the value of MR perfusion weighted imaging (PWI) in evaluating endometrial receptivity. Methods Twenty-two cases of infertility (infertility group) and 15 healthy women (control group) underwent MRI scan and PWI in mid-term. The intima-media thickness and intima-media thickness ), Peak time (TTP), mean enhancement time (MTE) and maximum enhanced linear slope (MSI) were calculated. The differences of perfusion parameters between the two groups were compared. The thickness of the intima between the two groups and the perfusion parameters were compared using two-sample t-test, and the Pearson method was used to determine the correlation between intima thickness and PEI. Results The difference of intima thickness between infertility group and control group was statistically significant (t = 6.54, P <0.01). There were significant differences in the values of PEI, MSI and MTE between the two groups (t = 2.45,2.12,2.23, P <0.05), but there was no significant difference between the two groups (t = 1.25, P> 0.05) There was no significant difference in perfusion parameters between the two groups (t = 1.42,1.00,2.03,1.75, P> 0.05). Endometrial thickness and PEI value of regression analysis showed a significant positive correlation (r = 0.763, P <0.01). Conclusion MR-PWI can quantitatively reflect the endometrial and subintimal blood perfusion, and there is a certain correlation between the thickness of the intima and blood volume, which has some value for the assessment of endometrial receptivity in infertile patients.