| Objective:The aims of this study were to analyze the morphological parameters of ovary and the characteristics of ovarian interstitial artery vascularization in PCOS patients with three-dimensional ultrasound,and to investigate the correlation between the morphological changes of PCOS ovary and the vascularization degree of ovarian interstitial artery and the levels of AMH and sex hormone in PCOS patients.Methods:102 patients with polycystic ovary syndrome who were clinically diagnosed by ultrasound examination in our hospital from May 2019 to January2020 were set as PCOS group.42 women of healthy childbearing age with regular menstrual cycle were selected as the control group.Three-dimensional ultrasound was used to detect antral follicle count（AFC）,ovarian volume（OV）,ovarian stroma artery vascular index（VI）,blood flow index（FI）,and vascularized blood flow index（VFI）.Serum levels of AMH,LH,FSH,E2and T were also detected.Results:1.The area under the ROC curve（AUC）of AFC,AMH,VI,FI,and VFI in the diagnosis of PCOS were 0.932,0.922,0.816,0.828,and 0.880,respectively.The optimal critical value for the diagnosis of PCOS by AFC was16,with a sensitivity of 89%and specificity of 86%.The optimal critical value for AMH diagnosis of PCOS was 5.40ng/ml,with a sensitivity of 86%and specificity of 88%.2.The AFC,OV,VI,FI and VFI of the ovarian interstitial artery in the PCOS group were significantly higher than those in the control group（P≤0.05）.3.AFC was strongly positively correlated with AMH（r=0.875,P≤0.05）,moderately positively correlated with LH,LH/FSH and T（r=0.500,0.524,0.567,P≤0.05）,and weakly correlated with FSH and E2（r=-0.227,0.189,P≤0.05）.OV was moderately positively correlated with AMH and LH/FSH（r=0.779,0.527,P≤0.05）,low positively correlated with LH and T（r=0.422,0.475,P≤0.05）,low negatively correlated with FSH（r=-0.334,P≤0.05）,and weakly correlated with E2（r=-0.266,P≤0.05）.4.VI was slightly positively correlated with AMH,LH,LH/FSH and T（r=0.414,0.327,0.364,0.352,P≤0.05）,and weakly correlated with FSH（r=-0.196,P≤0.05）.No significant correlation was found between VI and E2（P>0.05）.There were low positive correlations between FI and AMH,LH and LH/FSH（r=0.362,0.351,0.388,P≤0.05）,and weakly correlated with T（r=0.275,P≤0.05）.No significant correlation was found between FI and FSH,E2（P>0.05）.There were low positive correlations between VFI and AMH,LH,LH/FSH and T（r=0.465,0.432,0.461,0.410,P≤0.05）,andweaklycorrelated FSH（r=-0.187,P≤0.05）.No significant correlation was found between VFI and E2（P>0.05）.5.Serum AMH level was positively correlated with LH,LH/FSH and T（r=0.492,0.529,0.554,P≤0.05）,and weakly correlated with FSH and E2（r=-0.251,0.225,P≤0.05）.There was no significant correlation between AMH and BMI（P>0.05）.Conclusions:1.Sinus follicle counts and ovarian interstitial artery blood flow parameters detected by three-dimensional ultrasound have high diagnostic value for PCOS.2.The ovarian interstitial artery VI,FI and VFI of PCOS patients were higher than those of normal childbearing age women,and the degree of ovarian artery vascularization was significantly increased.3.The serum AMH level was positively correlated with AFC,OV and VI,FI,VFI of ovarian interstitial arteries,which can reflect the changes of ovarian morphology and hemodynamics in PCOS patients to some extent.4.The correlations between AFC,OV and serum AMH level were higher than that with LH,LH/FSH and T.Serum AMH level is better to reflect the changes of ovarian morphology of PCOS patients than sex hormones.5.The ovarian interstitial artery hemodynamic parameters VI,FI,VFI and AMH,LH,LH/FSH were all slightly positively correlated.The degree of ovarian interstitial artery vascularization can reflect the changes of endocrine hormones in PCOS patients to some extent. |
