Objective To investigate the relationship between ultrasound elastography parameters and clinical pathological features, ovarian reserve function in patients with endometriosis (EMs).

Methods A total of 220 patients with EMs were selected as the research subjects, and divided into the diminished ovarian reserve (DOR) group (75 cases) and non-DOR group (145 cases) according to the test results of ovarian reserve function. Two groups were detected using ultrasound elastography, and the shear wave velocity (SWV), minimum elasticity value (Emin), average elasticity modulus (Emean), maximum elasticity value (Emax), and strain rate ratio (SR) were recorded. The levels of ovarian reserve function indicatorsfollicle-stimulating hormone (FSH), anti-mullerian hormone (AMH) and estradiol (E2) and parameters of ultrasound elastography were compared between two groups. The influencing factors of DOR in EMs patients were analyzed, and a predictive model was constructed. The ROC curve was used to evaluate the diagnostic efficacy of ultrasound elastography parameters for DOR.

Results Compared with the non-DOR group, the AMH level in the DOR group was significantly lower, the FSH and E2 levels were significantly higher, and the SWV, Emean, Emax, Emin and SR were also significantly higher (P ＜ 0.01). In EMs patients, the SWV, Emean, Emax, Emin and SR were positively correlated with FSH and E2, while the Emax, SWV, Emin, SR and Emean were negatively correlated with AMH (P ＜ 0.05 to P ＜ 0.01). logistic analysis showed that age, r-AFS stage (stage Ⅲ - Ⅳ), bilateral lesions, maximum diameter of cyst, IL-6, TNF-α, SWV, Emean, Emax, Emin, and SR were all independent risk factors for DOR in EMs patients (P ＜ 0.05 to P ＜ 0.01). The results of logistic analysis showed that the age, r-AFS stage (stage Ⅲ - Ⅳ), bilateral lesions, maximum diameter of cyst, IL-6, TNF-α, SWV, Emean, Emax, Emin, and SR were the independent risk factors of DOR in EMs patients (P ＜ 0.05 to P ＜ 0.01). The DOR prediction model for EMs patients had a relatively high diagnostic efficacy, with an AUC of 0.95 (0.92–0.98). The consistency rate test was conducted on the established model, and the results showed that the consistency rate was 88.60%. The results of Hierarchical regression analysis showed that the age was positively correlated with all elastic parameters (P ＜ 0.05), and the r-AFS stage (stage Ⅲ - Ⅳ), maximum diameters of bilateral lesions and cysts were independently positively correlated with elastic parameters (P ＜ 0.05 to P ＜ 0.01). After further incorporating inflammatory factors, the IL-6 and TNF-α showed a significant positive correlation with elastic parameters (P ＜ 0.01).

Conclusions The Ultrasound elastography parameters have clinical diagnostic value in evaluating ovarian function in EMs patients. Combined with clinicopathological features, they can more accurately assess ovarian reserve function.