Diagnosis values of three-dimensional power Doppler ultrasonography in polycystic ovary syndrome and its relationship with serum sex hormone levels.

BACKGROUND: The diagnosis of polycystic ovary syndrome (PCOS) is of great significance for early detection, timely standardized treatment and prevention of long-term complications. This study aimed to observe and measure the intraovarian blood flow distribution and blood flow indexes in patients with PCOS by three-dimensional power Doppler ultrasonography, and to evaluate its diagnostic value for PCOS and its correlation with serum sex hormone levels. EXPERIMENTAL DESIGN: Patients who were diagnosed with PCOS and met the inclusion and exclusion criteria were recruited as the PCOS group, and 85 age-matched healthy women were arranged in healthy control (HC) group. Participants underwent three-dimensional power Doppler ultrasound. Serum sex hormone was analyzed by chemiluminescence. The diagnostic value was analyzed by relative operating characteristic (ROC) analysis. Spearman correlation coefficient analysis was applied to determine the correlation of vascularization index with serum sex hormone levels. RESULTS: The vascularization index (VI), flow index (FI), and vascularization flow index (VFI) values in PCOS patients were all statistically higher than those of HC. The combined index (0.445 * VI + 0.1 * FI + 1.057 * VFI) has a higher diagnostic value of PCOS compared with the three indexes alone. CONCLUSION: Three-dimensional power Doppler ultrasound could observe and quantitatively evaluate the distribution of blood flow in the ovary, which has a high diagnostic value and might provide a reference in clinical use.

Three-dimensional power Doppler ultrasonography indicates that increased placental blood perfusion during the third trimester is associated with the risk of macrosomia at birth.

PURPOSE: To investigate the association between placental blood perfusion and the occurrence of macrosomia at birth. METHODS: This was a prospective cohort study including women with singleton pregnancies that aimed to measure placental blood perfusion using three-dimensional (3D) power Doppler ultrasonography in the second and third trimester. We acquired three indices of placental blood flow, including vascularization index (VI), flow index (FI), vascularization flow index (VFI), along with routine two-dimensional (2D) biometric measurements, including abdominal circumference (AC) and estimated fetal weight (EFW). Pregnancy outcomes were divided into two groups: newborns with a normal birth weight and those with macrosomia. We then compared all of the recorded variables between these two groups. We also determined the predictive efficiency of each variable using receiver-operating characteristic (ROC) curves. RESULTS: The placental 3D power Doppler indices, including VI and FI, were significantly higher in the third trimester of pregnancies developing macrosomia, but not during the second trimester, as compared to those with a normal birth weight. ROC curves analysis for third-trimester VI and FI suggested a slight ability to predict macrosomia; this was also the case for AC and EFW. Interestingly, VI showed high sensitivity and low specificity, while FI showed low sensitivity and high specificity; this was also the case for AC and EFW. CONCLUSIONS: Three-dimensional power Doppler ultrasound indices were significantly higher during the third-trimester for pregnancies developing macrosomia. However, these indices had only moderate ability to predict macrosomia.

A Comparative Study on Quantitative Assessment of Blood Flow and Vascularization in Polycystic Ovary Syndrome Patients and Normal Women Using Three-Dimensional Power Doppler Ultrasonography.

PURPOSE OF THE STUDY: To compare the quantitative assessment of blood flow and vascularization of ovaries in polycystic ovary syndrome patients and normal women using three-dimensional power Doppler ultrasonography. METHODS: This cross-sectional quantitative study was conducted on women of reproductive age group (15-45 years) attending Gynaecology OPD AIMSR, Bathinda, Punjab. Thirty women were enrolled in polycystic ovarian syndrome (PCOS) group and 30 healthy women in control group. Women were categorized as polycystic ovary syndrome according to Rotterdam's criteria. The women with PCOS underwent transvaginal USG Doppler on day 6 of the cycle using 3D power Doppler USG equipment (GE Voluson E8), and vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were measured. RESULTS: The mean values of VI, FI and VFI measured by power Doppler ultrasonography were significantly increased (P value = 0.000) in women with PCOS when compared with healthy women. CONCLUSION: This study suggests that blood flow and vascularization measured by 3D power Doppler ultrasonography in ovaries of polycystic ovary syndrome patients were significantly more than the ovaries of normal women.

Logistic regression analysis of combining transvaginal conventional ultrasonography and 3D power Doppler ultrasonography(3D-PDUS) in differential diagnosis of ovarian tumor / 中华超声影像学杂志

Objective To develop a logistic regression model for differential diagnosis of the malignant ovarian tumor by combining transvaginal conventional ultrasonography and 3D power Doppler ultrasound(3D-PDUS) techniques. Methods The transvaginal ultrasonography and 3D-PDUS data were collected from 291 patients with ovarian tumors received clinical pathological diagnosis.According to the pathological resuts,the 291 patients were divided in to benign group(GB) and borderline/malignant group (GM). Univariate and multivariate logistic regression analyses were applied to establish models for predicting malignant tumor. Results ① Within the 291 ovarian tumor patients,175 (60.14% ) were classified as the GB and 116 (39.86% ) were considered as the GM,the number for postmenopausal cases and the serum CA125 level in GB group were significantly lower than those in GM group ( P <0.001); ②The tansvaginal conventional ultrasound analysis suggested that borderline/malignant tumor often presented as larger volume,more irregular shape,and higher incidence in the blood flow within a solid papillary projection and ascites (P< 0.05,compared with GB group);In 3D-PDSU data,the vascularization index (VI) was lower than that in GB group( P <0.001,compared with GM group),but there was no significant difference between GB group and GM group in flow index (FI) and vascularization-flow index (VFI) ( P =0.559,0.454); ③ Multivariate logistic regression analysis showed that postmenopausal status,serum CA125 levels,tumor echo,papillary with blood flow,ascites and 3D-PDUS VI parameters were independent risk factors for the progression of borderline/malignant tumor.The ROC curve showed that the established regression model accuracy was 92.0%,sensitivity was 86.2%,specificity was 95.7%,positive predictive value was 92.6% and negative predictive value was 91.7%. Conclusions Combining multi-model transvaginal conventional ultrasound and 3D-PDUS analyses is a useful non-invasive technique for the differential diagnosis of ovarian tumor.

Effect of pregestational diabetes mellitus on first trimester placental characteristics: three-dimensional placental volume and power Doppler indices.

OBJECTIVE: To investigate whether pregestational diabetes mellitus (DM) induces changes in vascular placental development detectable at first trimester. METHODS: This was a prospective case-control study in 69 women with pregestational DM and 94 controls undergoing first-trimester combined screening for aneuploidies. Maternal characteristics, fetal nuchal translucency thickness, maternal serum pregnancy-associated plasma protein A (PAPP-A) and free ß human chorionic gonadotrophin (ß-hCG) were evaluated. Three-dimensional ultrasound was used to measure placental volume and three dimensional power Doppler (3D-PD) placental vascular indices including: vascularization index (VI), flow index (FI) and vascularization flow index (VFI). Pregnancy-associated hypertensive complications (PAHC) and perinatal outcomes were analyzed. The total group of diabetic women and the group of diabetic women without PAHC were compared separately with the control group. RESULTS: 3D-PD placental vascular indexes were significantly lower in women with DM than in controls (VI p = 0.007, FI p = 0.003 and VFI p = 0.04). These differences remained on excluding cases with PAHC in the DM group. No differences were found in placental volumes between the DM group and controls. Serum PAPP-A levels were also lower in diabetic women (p < 0.02) and negatively correlated with the degree of maternal metabolic control at first trimester. CONCLUSIONS: Pregestational DM induces demonstrable alterations in first trimester placental development, with significantly reduced placental vascularization indices and PAPP-A values. This effect is independent of the later development of PAHC.