PDF(Pubmed)
Abstract：
We aimed to describe physiological changes in endometrial blood flow (minute arterioles running through the endometrium) from ovulation to the mid-luteal phase using superb microvascular imaging.
The study involved 17 women (median age, 32.5 years; first to third interquartile range, 29.8-40.0 years) with regular menstrual cycles who were managed in our institute from 2020 to 2021. The uterus was delineated at the sagittal section using transvaginal ultrasonography incorporated with superb microvascular imaging. For each participant, a total of 28 cycles were observed; 17 cycles observed within one day of ovulation and the implantation period, 5-7 days (D5-7) after ovulation in the same cycle, and nine cycles in which only ovulation was observed, and two cycles in which only D5-7 was observed. Therefore, 26 and 19 images at ovulation and D5-7, respectively, were acquired. Endometrial blood flow was evaluated by depth of the vascular signal in the endometrium and categorized as follows: signals only in the basal layer of the endometrium (grade 1), reaching up to half the endometrium (grade 2), and covering the whole endometrium (grade 3). Changes in the grade of endometrial blood flow from ovulation to D5-7 after ovulation, and the relationship between the grade of endometrial blood flow and the endometrial thickness on ovulation and D5-7 after ovulation, were analyzed. Statistical significance was set at p < 0.05.
The endometrial blood flow from ovulation to D5-7 after ovulation during the same menstrual period showed a downgrade in 14 of 17 cycles (82.3%) and no change in the remaining three cycles (17.6%), indicating a decrease in the endometrial blood flow from ovulation to D5-7 after ovulation (p = 0.001). There were differences between the grade of endometrial blood flow and median endometrial thickness on ovulation (grade 1: 5.9 mm, grade 2: 9.1 mm, and grade 3: 11.2 mm); however, no differences in the endometrial thickness were found between the grades on D5-7 after ovulation.
In the normal menstrual cycle, endometrial blood flow decreased from ovulation to the mid-luteal phase, and the endometrial thickness in the ovulatory phase was related to the endometrial perfusion.
The study involved 17 women (median age, 32.5 years; first to third interquartile range, 29.8-40.0 years) with regular menstrual cycles who were managed in our institute from 2020 to 2021. The uterus was delineated at the sagittal section using transvaginal ultrasonography incorporated with superb microvascular imaging. For each participant, a total of 28 cycles were observed; 17 cycles observed within one day of ovulation and the implantation period, 5-7 days (D5-7) after ovulation in the same cycle, and nine cycles in which only ovulation was observed, and two cycles in which only D5-7 was observed. Therefore, 26 and 19 images at ovulation and D5-7, respectively, were acquired. Endometrial blood flow was evaluated by depth of the vascular signal in the endometrium and categorized as follows: signals only in the basal layer of the endometrium (grade 1), reaching up to half the endometrium (grade 2), and covering the whole endometrium (grade 3). Changes in the grade of endometrial blood flow from ovulation to D5-7 after ovulation, and the relationship between the grade of endometrial blood flow and the endometrial thickness on ovulation and D5-7 after ovulation, were analyzed. Statistical significance was set at p < 0.05.
The endometrial blood flow from ovulation to D5-7 after ovulation during the same menstrual period showed a downgrade in 14 of 17 cycles (82.3%) and no change in the remaining three cycles (17.6%), indicating a decrease in the endometrial blood flow from ovulation to D5-7 after ovulation (p = 0.001). There were differences between the grade of endometrial blood flow and median endometrial thickness on ovulation (grade 1: 5.9 mm, grade 2: 9.1 mm, and grade 3: 11.2 mm); however, no differences in the endometrial thickness were found between the grades on D5-7 after ovulation.
In the normal menstrual cycle, endometrial blood flow decreased from ovulation to the mid-luteal phase, and the endometrial thickness in the ovulatory phase was related to the endometrial perfusion.
摘要：
背景：我们的目的是使用极好的微血管成像来描述从排卵到黄体中期的子宫内膜血流（穿过子宫内膜的微小小动脉）的生理变化。
方法：该研究涉及17名女性（中位年龄，32.5年；第一至第三四分位数范围，29.8-40.0年），有规律的月经周期，从2020年到2021年在我们研究所管理。使用经阴道超声检查结合极好的微血管成像在矢状切面描绘子宫。对于每个参与者，共观察到28个周期；在排卵和着床期的一天内观察到17个周期，在同一周期排卵后5-7天（D5-7），九个周期中只观察到排卵，和仅观察到D5-7的两个循环。因此,排卵和D5-7时分别有26和19张图像，被收购了。通过子宫内膜血管信号的深度评估子宫内膜血流，并分类如下：仅子宫内膜基底层的信号（1级），达到子宫内膜的一半（2级），覆盖整个子宫内膜（3级）。从排卵到排卵后D5-7子宫内膜血流分级的变化,排卵时子宫内膜血流分级与子宫内膜厚度及排卵后D5-7的关系,进行了分析。统计学显著性设定为p<0.05。
结果：在同一月经期，从排卵到排卵后D5-7的子宫内膜血流量在17个周期中有14个（82.3%）下降，其余3个周期（17.6%）无变化，表明从排卵到排卵后D5-7的子宫内膜血流量减少（p=0.001）。子宫内膜血流分级与排卵时子宫内膜厚度中位数存在差异(1级:5.9mm,等级2:9.1mm,和等级3：11.2毫米)；然而，排卵后D5~7级子宫内膜厚度无差异.
结论：在正常月经周期中，子宫内膜血流量从排卵到黄体中期减少，排卵期子宫内膜厚度与子宫内膜灌注有关。
方法：该研究涉及17名女性（中位年龄，32.5年；第一至第三四分位数范围，29.8-40.0年），有规律的月经周期，从2020年到2021年在我们研究所管理。使用经阴道超声检查结合极好的微血管成像在矢状切面描绘子宫。对于每个参与者，共观察到28个周期；在排卵和着床期的一天内观察到17个周期，在同一周期排卵后5-7天（D5-7），九个周期中只观察到排卵，和仅观察到D5-7的两个循环。因此,排卵和D5-7时分别有26和19张图像，被收购了。通过子宫内膜血管信号的深度评估子宫内膜血流，并分类如下：仅子宫内膜基底层的信号（1级），达到子宫内膜的一半（2级），覆盖整个子宫内膜（3级）。从排卵到排卵后D5-7子宫内膜血流分级的变化,排卵时子宫内膜血流分级与子宫内膜厚度及排卵后D5-7的关系,进行了分析。统计学显著性设定为p<0.05。
结果：在同一月经期，从排卵到排卵后D5-7的子宫内膜血流量在17个周期中有14个（82.3%）下降，其余3个周期（17.6%）无变化，表明从排卵到排卵后D5-7的子宫内膜血流量减少（p=0.001）。子宫内膜血流分级与排卵时子宫内膜厚度中位数存在差异(1级:5.9mm,等级2:9.1mm,和等级3：11.2毫米)；然而，排卵后D5~7级子宫内膜厚度无差异.
结论：在正常月经周期中，子宫内膜血流量从排卵到黄体中期减少，排卵期子宫内膜厚度与子宫内膜灌注有关。
