Transvaginal color Doppler sonography predicts ovarian interstitial fibrosis and microvascular injury in women with ovarian endometriotic cysts

Abstract

Objective. To determine novel predictors of ovarian interstitial fibrosis and microvascular injury associated with ovarian endometriotic cysts (OECs). Design. Case-control study. Setting. The gynecology unit of an affiliated hospital in China. Population. Women <40 years of age with OECs or benign ovarian tumors (controls). Methods. Transvaginal color Doppler sonography was performed preoperatively to detect ovarian interstitial flow. Postoperatively, expressions of transforming growth factor-β1 (TGF-β1) and thrombospondin-1 (TSP-1), as well as microvessel density in ovarian interstitial, were analyzed using immunohistochemistry. Main outcome and measures. Ovarian interstitial flow and expressions of TGF-β1, TSP-1, and microvessel density. Results. Compared with controls, ovarian interstitial flow in the study group was decreased and arterial spectra indicated significantly higher resistance indices. Microvessel density was reduced, but TGF-β1 and TSP-1 were elevated in the study group. There was a positive correlation between TGF-β1 and TSP-1. There were negative correlations between TGF-β1 and microvessel density, and between TSP-1 and microvessel density. Microvessel density and resistance indices were negatively correlated, whereas the correlations of TGF-β1 and TSP-1 with resistance indices were positive. Conclusions. Resistance indices are consistent with pathological indices. Changes in resistance indices in ovaries with endometriosis are related to interstitial fibrosis and microvascular injury. © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.