摘要目的:探讨三维超声检查对U4b型单角子宫不孕症患者子宫内膜容受性（ER）的评估价值。方法:将2017年1月至2020年6月山西医科大学第一医院收治的78例U4b型单角子宫不孕症患者（U4b组）与60例正常同龄妇女（对照组）纳为研究对象。采用三维能量多普勒超声（3D-PDA）技术，检测两组子宫内膜类型、厚度、容积及子宫内膜下血流参数等指标，并对U4b型单角子宫不孕症患者的子宫内膜容受性进行分析。结果:（1）U4b组子宫内膜类型A、B、C型分布比率分别为38.46%、25.64%和35.90%，而对照组子宫形态集中在A型（65.00%），两组子宫内膜类型比较，差异有统计学意义（ P<0.05）。（2）两组平均子宫内膜厚度比较，差异无统计学意义（ P>0.05）；但两组子宫内膜厚度分级比较，差异有统计学意义（ P<0.05），U4b组子宫内膜厚度主要集中于≥14 mm（30.77%）及<10 mm（41.03%），而对照组子宫内膜厚度集中在10~13 mm（75.00%）。（3）U4b组平均子宫内膜容积低于对照组（ P<0.05），其中U4b组主要集中在1~2 ml（67.95%），而对照组主要集中在≥3 ml范围（68.33%）。（4）两组子宫内膜的血管化指数（VI）、血流指数（FI）及血管化血流指数（VFI）比较，差异无统计学意义（ P>0.05），但U4b组内膜下的VI、FI、VFI低于对照组（ P<0.05）。 结论:相对于正常妇女，三维超声检查提示U4b型单角子宫不孕症患者的子宫内膜类型、厚度、容积及内膜内血流参数均发生明显改变，说明其ER状态异常，可能影响受孕。

abstractsObjective:To investigate the value of three-dimensional ultrasonography in evaluat-ing endometrial receptivity (ER) in infertile women with class U4b uni-cornuate uterus.Methods:Included in this study were 78 infertile women with class U4b unicornuate uterue (U4b group) and 60 age-matched, normal women (control group) admitted to the First Hospital of Shanxi Medical University between January 2017 and June 2020. Three-dimensional power Doppler angiography (3D-PDA) techniques were used to examine the pattern, thickness and volume of the endometrium, as well as subendometrial blood flow in the two groups. The ER in infertile women with class U4b unicornuate uterus was thereby evaluated.Results:(1) The proportions of endometrial patterns A, B, and C in the U4b group were 38.46%, 25.64%, and 35.90%, respectively, in contrast to the con-trol group in which pattern A was the predominant endometrial pattern (65.00%) ; the difference was statistically significant ( P<0.05) . (2) The mean endometrial thickness did not differ statistically between the two groups ( P>0.05) . However, there was a significant difference in the clas-sification of endometrial thickness between the two groups ( P<0.05) . The endometrial thickness was more frequently to be ≥14 mm (30.77%) or <10 mm (41.03%) in the U4b group, compared with 10-13 mm (75.00%) as frequently found for the control gorup. (3) The mean endometrial vol-ume was lower in the U4b group than that in the control group ( P<0.05) . In the U4b group, the endometrial volume frequently measured 1-2 ml (67.95%) , compared with ≥3 ml (68.33%) as freqently found for the control group. (4) There were no significant differences in the vasculari-zation index (VI) , flow index (FI) and vascularization-flow index (VFI) of the endometrium between groups ( P>0.05) . However, the subendo-metrial VI, FI and VFI were lower than in the U4b group than those in the control group ( P<0.05) . Conclusion:Infertile women with class U4b unicornuate uterus show significantly altered pattern, thickness, volume and blood flow of the endometrium compared with normal women on three-dimensional ultrasonography, indicating abnormal endometrial re-ceptibility in these patients that may interfere with conception.