Дифференциальная ультразвуковая диагностика поликистозных и мультифолликулярных яичников у девушек 15-18 лет

In: Медицинская визуализация · 2015 · pp. 116–130 · W2896704973
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Abstract

Objective: to develop a differential diagnostic ultrasound criteria multifollicle and polycystic ovaries in girls 15-18 years. Materials and methods. The study involved 394 women 15-18 years old. In 172 patients diagnosed with polycystic ovary syndrome (group 1), 95 - multifollicular ovaries (group 2). The control (group 3) reached 127 people. In each group, the girls are divided by age: 15-16 years and 17-18 years. All patients were performed organometric including uterine volume, thickness and volume of the endometrium, ovary volume, the diameter of maximum of the follicle and corpus luteum diameter. Then the degree of vascularization of ovarian was assessed using vascularization index (VI) was carried out and both uterine artery Doppler measurement with their diameter. Then the degree of vascularization was assessed using ovarian vascularization index (VI) and carried both uterine artery Doppler monitoring their diameter. The indices of maximum systolic velocity (Vmax), end-diastolic velocity (Vmin), mean, averaged over time, blood flow velocity (TAMV), pulse index (PI) and resistance index (IR). The final step was the assessment of hemodynamics calculation arterial perfusion index (PAI) of the uterus. Results. Revealed that the girls 15-18 years continues functional formation of pelvic terms of increased endometrial thickness and volume in the II phase of the cycle in comparison with I phase, the diameter of the corpus luteum and improve perfusion of the uterus and ovaries with increasing age. For multifollicular ovarian characteristic increase in the size of the ovaries, which occurs in some women folliculogenesis and ovulation. For polycystic ovary characterized by deeper violations. The volume of the ovaries has no minimum 9 cm 3 , maximum - 34.5 cm 3 with the average 14.5-17.8 cm 3 , which increases as the girls. In the ovaries of girls of 15-18 years old are no dominant follicle and, accordingly, the corpus luteum. PCO reduced vascularization, with values vascularization index from 0% to 8.0%. Resistance index of the uterine arteries is high, reaching 1.0 in 38.8% of girls aged 17-18 and 50.7% - among 15-16 year olds. In addition, when PCO marked slowdown in the uterus, and therefore the uterine hypoplasia was present in 15-16-year-olds in 34.8% of patients and in 17-18-year-olds in 22.3%. Also recorded monotonous thicknesses and volume of the endometrium, did not increase in the II phase of the cycle. Conclusion. Teens 15-18 years with suspected polycystic ovaries during ultrasound diagnosis is competent only if the registration is not only the increase of ovarian volume, but also taking into account the functional activity of the ovary, its vascularization, endometrial changes in both phases of the cycle and assess uterine volume. Girls with MFO should be attributed to the risk group for the development of PCOS, especially those who have menstrual irregularities.

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