MRI及超声测量育龄期女性卵巢及卵泡结构随月经周期变化的方法学比较

摘要

目的:对比MRI与超声研究育龄期女性卵巢形态、卵泡数目随月经周期变化的规律,比较两种方法对卵巢径线测量及卵泡计数的差异,为健康育龄期女性在月经不同期别的卵巢径线、体积、卵泡数目等提供参考值.方法:26例志愿者分别于月经期、卵泡期、围排卵期、黄体期行盆腔MRI扫描及超声检查.记录MRI与超声测量的卵巢体积、卵泡个数、最大及次大卵泡直径在不同月经周期中的数据,并进行统计学分析.结果:MRI测量的双侧卵巢左右径(左侧P值=0.003,右侧P值=0.000)、前后径(左侧P值=0.000,右侧P值=0.000)、体积(左侧P值=0.000,右侧P值=0.000)、总卵泡数(左侧P值=0.003,右侧P值=0.000)及右卵巢长径(P=0.000)大于超声测量值,左卵巢长径测量值小于超声测量值(P=0.000)oMRI及超声均发现左、右最大卵泡、总最大卵泡直径随月经周期而变化,围排卵期最大卵泡直径最大,MRI测量值为月经期(0.90±0.28)cm,卵泡期(1.24±0.31)cm,围排卵期(1.71士0.54)cm,黄体期(1.20±0.66) cm;超声测量值为月经期(1.01±0.40) cm,卵泡期(1.26±0.46) cm,围排卵期(1.47±0.47)cm,黄体期(0.89士0.37) cm.两种检查方法均显示双侧卵巢体积在月经周期内变化不明显.结论:MRI测量的卵巢径线、体积大于超声测量结果,卵泡计数MRI显著多于超声,MRI与超声在卵巢及卵泡解剖结构定量测量中有显著差异.超声及MRI均可发现左、右侧最大卵泡直径随月经周期而变化.%Objective:To compare MR imaging with ultrasonography performed at the same day during different phases of menstrual cycle in the evaluation of dimensions of ovaries and number of follicles,and thus to investigate morphological changes of the normal ovaries and follicles in healthy child-bearing age women during the menstrual cycle.Methods:MR examinations of the pelvis were performed in 26 healthy women between 20 to 40 years old (mean,29 yrs).Each volunteer underwent totally four MR and ultrasound scans in menstrual phase (MP),follicular phase (FP),ovulatory phase (OP) and luteal phase (LP).Axial,coronal and sagittal T2 weighted images and axial T1 weighted images were obtained on a 3.0T MR scanner.Ovarian and follicular measurements were acquired on T2 WI.T1WI were used for diagnosis of ovarian anomaly.One-way analysis of variance,paired student t test and liner mixed models were preformed using SPSS statistics 19.0.Results:26 volunteers were included in our study (mean age:29.1 years,average BMI:20.3kg/m2 and average height:1.61m).Mean value of ovary dimensions,number of follicles and dimension of the biggest follicles were compared between MR imaging and ultrasonography.Both left and right ovarian volume and number of follicles acquired on MR were larger than that on ultrasound (P =0.000 ～ 0.003).Cyclic changes were found on left,right and overall maximum follicle diameter with the biggest diameter in LP.The maximum follicle diameter acquired by MR during menstrual cycle was as follows:MP (0.90 ± 0.28)cm,FP (1.24 ± 0.31)cm,OP (1.71 ± 0.54)cm,and LP (1.20 ± 0.66)cm;however,the maximum follicle diameter obtained by ultrasound was MP (1.01 ± 0.40)cm,FP (1.26 ± 0.46)cm,OP (1.47 ± 0.47)cm,and LP (0.89 ± 0.37)cm.The ovarian volume change was not obvious.Conclusion:There was statistical significant difference in the measurement of ovary and follicular structure between using MR and ultrasound,with bigger values obtained by MR.The changes of maximum follicle diameter during menstrual cycle were observed on both MR and ultrasound.