Doppler Assessment of Uterine and Intraovarian Blood Flow in Patients with Genital Endometriosis
DOI:
https://doi.org/10.14739/2310-1210.2017.4.105039Keywords:
endometriosis, blood velocity, ultrasonicsAbstract
The spread of endometriosis among women of reproductive age is 5–10 %. Forming of endometrioid foci commonly begins from development of new blood vessels. So, changes of hemodynamics in vessels that can be determined by Doppler are important for complete diagnosis of endometriosis.
Aim of research was to evaluate the uterine and intraovarian hemodynamic changes in women with internal and external genital endometriosis.
Materials and methods. The research included 65 women with diagnosis of external genital endometriosis who formed the Ist group. 38 women with internal genital endometriosis were included into the IInd group. Control group involved 30 women without genital endometriosis. Doppler study was set in both phases of menstrual cycle with determination of uterine and intraovarian pulsatility index, resistance index and systolic/diastolic ratio in uterine arteries.
Results. In patients with endometriosis we found hemodynamic disturbances in uterine arteries of varying degrees which depended on localization of the pathological process and its stages. In women of I group with I and II stages of external endometriosis indices of peripheral vascular resistance did not differ significantly from parameters of the control group. There was moderate increase of vascular resistance indices higher over healthy women (P < 0.05) in this group in patients with III stage. Increase of peripheral vascular resistance was detected, which grew rapidly according to severity of disease by II-III stages of internal endometriosis. Critical changes of circulation in form of dicrotic notch were detected in 31.58 % of patients with III stage of internal endometriosis. In half of all cases dicrotic notches were symmetrical in both uterine arteries. In addition, in 36.84 % of patients with III degree of internal endometriosis negative blood flow in diastole phase was determined.
Significant important difference of pulsatility index and resistance index in intraovarian velocity between healthy women and patients with internal and external endometriosis was not determined, except persons with endometriod cysts, who had resistant index of intraovarian circulation in both phases of the menstrual cycle over 0.55.
Conclusions. Blood velocity in uterine arteries during menstrual cycle in patients with genital endometriosis demonstrated highly resistant blood flow in women with external (III stage) and internal (II–III stages) endometriosis and intraovarian velocity (in persons with endometriod cysts). Decompensated changes in blood velocity in uterine arteries were observed only in patients with III stage of internal endometriosis.
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