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대한생식의학회지 제25권 제2호 2010년
정상 월경주기를 가진 불임환자에서 질식초음파검사를 이용한 자궁내막 형태 및 두께의 변화 양상에 관한 연구
서울대학교 의과대학 산부인과학교실
서창석, 김석현, 최영민, 김정구, 문신용, 이진용,
Transvaginal ultrasonographic analysis of endometrial pattern and thickness changes during normal menstrual cycle
Suh cs, Kim sh, Choi ym, Kim jg, Moon sy, Lee jy
The objective of this retrospective study was to evaluate whether the transvaginal ultrasonographical analysis of endometrial pattern and thickness could predict the stage of menstrual cycle. Endometrial pattern and thickness were observed in those patients with infertility during infertility work up from April, 1994 to July, 1998 at Seoul National University Hospital. The study group was 185 patients with normal regular menstrual cycles. Among them, 44 patients received endometrial biopsy that the date of endometrium was compared with observed endometrial pattern and thickness. The observed endometrial pattern was presence or absence of central cavity echogenicity, triple line sign, endometrial hypoechogenicity, ring sign, endometrial hyperechogenicity and posterior acoustic sonic enhancement. The results were as follows; Central cavity echogenicity was seen throughout menstrual cycle. Triple line sign was observed in 81.1% of patients during early secretory phase. However, in mid to late secretory phase, triple line sign was appeared in only 6.8%. The percentage of positive endometrial hypoechogenicity was highest in early secretory phase. In contrast to hypoechogenicity, positive endometrial hyperechogenicty was highest in mid to late secretory phase. Ring sign was observed in 73.5% of the patients during early secretory phase with peak incidence. Posterior acoustic enhancement was seen in 72.7% of the patients during late secretory phase. The sensitivity and specificity of being a secretory phase if the patients showed hyperechogenic endometrium, were 84.2%, 83.3% respectively. The sensitivity and specificity of being a secretory phase if the patients showed posterior acoustic enhancement were 93.8%, 58.3% respectively. Endometrial thickness was not correlated with endometrial dating. In conclusion, transvaginal ultrasonographical delineation of the endometrial pattern might be useful tool in predicting endometrial status during normal menstrual cycle. But, endometrial thickness could not predict the endometrial dating.
키워드 : Transvaginal ultrasonography, endometrial pattern, endometrial thickness
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