Prediction value of 3D-PDUS blood flow parameters for recurrence after hysteroscopic adhesion decomposition in patients with severe intrauterine adhesions
Li Yin, Li Jiying, Hu Hongwen, et al
(Department of Gynecology, the Third People's Hospital of YunnanProvince, Yunnan, Kunming 650000, China)
Abstract: 【Abstract】 Objective To investigate the predictive value of blood flow parameters measured by threedimensionalenergy Doppler ultrasound (3D-PDUS) for recurrence after hysteroscopic adhesion decompositionin patients with severe intrauterine adhesions (IUA) . Method A total of 100 cases with severe IUAwho underwent hysteroscopic adhesion decomposition at the Third People's Hospital of Yunnan Province fromJanuary 2021 to December 2022 were selected as the study. 3D-PDUS was performed before and one month aftersurgery to obtain vascularization index (VI)、flow index (FI)、vascularization-flow index (VFI) of bloodflow parameters. According to the recurrence situation 3 months after the operation, the patients were dividedinto recurrence group and non-recurrence group, and the influencing factors of postoperative recurrence wereanalyzed. The predictive value of VFI, VI, and FI for postoperative recurrence was evaluated. The statisticalmethods performed by t-test, χ2-test, Logistic regression analysis and receiver operating characteristic (ROC)curve analysis. Result VI (0.56±0.22 vs 0.14±0.06, t=18.418), FI (22.67±2.34 vs 17.62±2.39, t=15.098),and VFI (0.98±0.47 vs 0.07±0.03, t=19.322) in patients with severe IUA was higher after surgery than beforesurgery (P<0.001). The patients in recurrence group were lower than those in non-recurrence group in VI(0.31±0.15 vs 0.65±0.24, t=6.869), FI (15.1±2.1 vs 25.5±2.5, t=18.930), VFI (0.67±0.17 vs 1.09±0.25,t=8.055), (P<0.001).The random forest algorithm showed that the top five variables in importance score werepostoperative VFI, VI, FI, number of induced abortions, and disease duration; postoperative VFI (OR=0.279, 5%CI: 0.137-0.569), VI (OR=0.257, 95%CI: 0.122-0.541), FI (OR=0.275, 95%CI: 0.125-0.603), number ofnduced abortions (OR=5.702, 95%CI: 1.258-25.841), and disease duration (OR=5.976, 95%CI: 1.301-27.449)were factors affecting postoperative recurrence, all P<0.001; the area under the curve (AUC) of single andcombined prediction of VFI, VI and FI were 0.744, 0.837, 0.799 and 0.938, respectively, and the AUC of combinedprediction were higher than that of single prediction (P<0.001). Conclusion Blood flow parameters VI, FI andVFI increased after hysteroscopic adhesion decomposition in patients with severe IUA. Combined detection ofblood flow parameters has certain predictive value for postoperative recurrence.
李寅 李继英 胡红文 罗芳. 3D-PDUS 血流参数对宫腔镜下重度宫腔黏连分解术后复发的预测价值[J]. 发育医学电子杂志, 2024, 12(3): 204-209.
Li Yin, Li Jiying, Hu Hongwen, et al. Prediction value of 3D-PDUS blood flow parameters for recurrence after hysteroscopic adhesion decomposition in patients with severe intrauterine adhesions. Journal of Developmental Medicine(Electronic Version), 2024, 12(3): 204-209.
2024, Vol. 12 
