磁共振首过灌注成像对不孕患者子宫内膜容受性评估价值的分析-妇产科学专业论文.docx

三峡大学硕士学位论文 三 峡 大 学 硕 士 学 位 论 文 平台型。与健康对照组相比，不孕组研究对象内膜及内膜下感兴趣区灌注曲线上升支 稍平缓，即斜率稍减小，平台高度亦降低。3）不孕组内膜 MR 灌注参数 PEI、MSI、 TTP、MTE 分别为 244.03±138.40,136.52±49.10,233.48±73.61,968.64±85.01，对照 组内膜参数 PEI、MSI、TTP、MTE 值为 361.20±149.07,185.32±79.48,262.67± 64.03,809.82±267.38，两组间各参数采用两样本均数 t 检验，PEI、MSI、MTE 值差 异具有统计学意义，t 值分别为 2.451（p＜0.05）,2.118（p＜0.05）,2.225（p＜0.05）。 不孕组内膜下区感兴趣区灌注参数 PEI、MSI、TTP、MTE 分别为 139.62±99.87,127.1 ±83.86,144.16±94.30,886.99±38.68，对照组内膜相应值为 187.17±100.46,151.47± 47.80，191.25±45.05,863.73±41.37，两组间各参数比较差异均无显著性。4）分泌中 期不孕组与健康对照组在子宫内膜厚度及内膜 ROI 灌注参数 PEI 间比较，差异具有统 计学意义，可以评估子宫内膜血供情况。子宫内膜厚度与 PEI 值进行回归分析,二者 之间呈明显正相关，r=0.763，p＜0.01。 结论:MR-PWI 能够反映子宫内膜及内膜下的血供状态，在临床中可作为不孕患 者定量监测内膜血供状态的方法，且在发现常规超声所不易发现的肌壁间小的病灶上 有一定的优势，提示可以用于不孕患者子宫内膜容受性的评估。 关键词：不孕 子宫内膜容受性 血流灌注 磁共振 首过灌注加权成像 III Ⅳ Ⅳ Abstract Objective: To determinate the blood flow perfusion level of endometrial and subendometrial areas of infertility with MR perfusion-weighted imaging, and compare the difference with that of normal child-bearing period female. To approach the correlation between endometrial thickness and endometrial blood flow perfusion, and the relationship between blood flow perfusion level of endometrial and subendometrial and endometrial receptivity. To explore the feasibility of using MR-PWI as one index to evaluate the endometrial receptivity of infertility after treatment, so as to establish theory basis for clinics to institute therapy schema. Methods: 1) Collect 22 cases of infertility patients as test team, and 15 cases normal child-bearing period females as control group, all study cases with regular menstruation periodicity(28-30d) performed 1.5T MR imaging examination among 19th and 22nd of menstruation periodicity, routine scanning include T1 and T2 weighted imaging of uterine standard axial plane, T2 weighted imaging of coronal and sagittal plane; In MR-PWI scanning we started the LAVA sequence 18 cycles continuously while injecting contrast agent Gd-DTPA with high pressure injector from uln