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中华妇幼临床医学杂志(电子版) ›› 2020, Vol. 16 ›› Issue (05) : 527 -534. doi: 10.3877/cma.j.issn.1673-5250.2020.05.005

所属专题： 文献；

《美国放射学院适宜性标准：女性不孕》2020年版要点解读
韩雪盈1, 马春燕2, 程燕3, 杨帆4, 闵玲5, 黄子星6,†()   
  1. 1. 克拉玛依市人民医院（中医医院）医学影像科，新疆维吾尔自治区　834000
    2. 克拉玛依市人民医院（中医医院）超声科，新疆维吾尔自治区　834000
    3. 四川大学华西第二医院放射科，成都　610041
    4. 四川大学华西第二医院超声科，成都　610041
    5. 四川大学华西第二医院妇产科，成都　610041
    6. 四川大学华西医院放射科，成都　610041
  • 收稿日期:2020-09-01 修回日期:2020-09-15 出版日期:2020-10-01
  • 通信作者: 黄子星

Interpretation of ACR Appropriateness Criteria® Female Infertility (2020 Edition)

Xueying Han1, Chunyan Ma2, Yan Cheng3, Fan Yang4, Ling Min5, Zixing Huang6,†()   

  1. 1. Department of Medical Imaging, People′s Hospital of Karamay City (Hospital of Traditional Chinese Medicine), Karamay 834000, Xinjiang Uygur Autonomous Region, China
    2. Department of Ultrasonography, People′s Hospital of Karamay City (Hospital of Traditional Chinese Medicine), Karamay 834000, Xinjiang Uygur Autonomous Region, China
    3. Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    4. Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    5. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    6. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2020-09-01 Revised:2020-09-15 Published:2020-10-01
  • Corresponding author: Zixing Huang
  • Supported by:
    Sichuan Province Regional Innovation Cooperation Project(2020YFQ0016)
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引用本文：

韩雪盈, 马春燕, 程燕, 杨帆, 闵玲, 黄子星. 《美国放射学院适宜性标准：女性不孕》2020年版要点解读[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(05): 527-534.

Xueying Han, Chunyan Ma, Yan Cheng, Fan Yang, Ling Min, Zixing Huang. Interpretation of ACR Appropriateness Criteria® Female Infertility (2020 Edition)[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2020, 16(05): 527-534.

目前研究发现，导致育龄女性不孕的最常见原因包括男性因素、排卵障碍和输卵管损伤，但是迄今仍有部分夫妇的不育原因未明。导致女性不孕的自身原因包括卵母细胞质量下降、排卵障碍、输卵管炎症、子宫内膜异位症(EMS)及宫腔异常等。2020年5月，美国放射学院(ACR)发布针对女性不孕的适宜性标准。该标准对女性不孕的上述原因进行讨论，并针对特定病因提供相应的影像学检查建议及治疗程序的适用性。笔者就ACR对不同病因，如排卵功能和卵巢储备能力异常、具有多囊卵巢综合征(PCOS)临床特征或病史、EMS病史或临床疑诊为该病、疑似输卵管阻塞及复发性妊娠丢失女性不孕症患者的首选影像学检查建议进行解读。

关键词: 不育, 女(雌)性, 适宜性标准, 子宫输卵管造影术, 磁共振成像, 超声检查, 子宫内膜异位症, 多囊卵巢综合征

The most common known causes of female infertility are male factor, ovulatory failure, and tubal damage, while some couple′s infertility remains unexplained. Female-specific causes of infertility include deterioration of oocyte quality, ovulatory disorders, history of salpingitis, endometriosis (EMS), and uterine cavity abnormalities. In May 2020, the American College of Radiology (ACR) released appropriateness criteria on female infertility. The above potential causes of female infertility were discussed in this document and the appropriateness of imaging examination technologies and treatment procedures for specific clinical scenarios were recommended.The authors of this study intend to briefly interpret the ACR′s recommendations to the first line imaging examination among 5 clinical variants in female infertility, such as abnormality of ovulatory function and ovarian reserve, clinical features or history of polycystic ovary syndrome (PCOS), history or clinical suspicion of EMS, suspicion of tubal occlusion, and recurrent pregnancy loss.

Key words: Infertility, female, Appropriateness criteria, Hysterosalpingography, Magnetic resonance imaging, Ultrasonography, Endometriosis, Polycystic ovary syndrome
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