Is ultrasound useful in the diagnosis of adolescents with polycystic ovary syndrome?

Abstract

Background: Diagnosis of adolescent polycystic ovary syndrome (PCOS) remains a challenge despite several existing criteria, and may be difficult to distinguish from pubertal changes. Different parameters to study ovarian function using ultrasonography have been proposed, but there is still no consensus about their diagnostic value. Objective: To evaluate the role of ultrasonography in the diagnosis of adolescent PCOS by reviewing available studies that assessed the ovarian volume (OV) and other ovarian morphological features such as location and number of follicles, stromal area, and volume. Methods: MEDLINE/PubMed database were searched to identify studies that assessed ovarian characteristics of adolescent PCOS patients by ultrasound. Studies on adults were also reviewed if study population included adolescents and stromal characteristics were assessed by three-dimensional (3D) sonogram. Results: Five studies, including 262 PCOS adolescents (10-19 years of age) and two-dimensional (2D) ultrasound analysis, were identified. Mean OV was 9.29 cm 3 for PCOS patients and 4.77 cm 3 for controls. The morphology of ovarian follicles, when reported, showed multiple ( > 10) peripheral follicles in 83% of cases. Two studies, including 157 PCOS adolescents and young women (15-35 years of age) and 2D and 3D ultrasound analysis, were identified. Patients with PCOS patients had a MOV 13.1 cm

Is shear wave elastography relevant in the diagnosis of polycystic ovarian syndrome?

“…In addition to factors such as age and ethnicity which may cause changes in ovarian volume, PCOM appearance and volume increase in women with completely normal physiology have led to the search of new diagnostic criteria for PCOS [8,27,31]. Although new diagnostic criteria, such as increasing the number of cysts from 12 to 25, the use of stromal volume / total ovarian volume ratio and Doppler US were studied, none of them have gained general acceptance [18,[32][33][34][35][36].…”

“…However, these criteria are particularly controversial for the diagnosis of PCOS in adolescents [7]. In ultrasound, polycystic ovarian appearance can be mistaken for other diseases or even misdiagnosed in healthy subjects [8,9].…”

Diagnosis and Management of Polycystic Ovary Syndrome in Adolescent Girls

“…While studies confirm increased ovarian volume and classic morphology in PCOS affected adolescents compared with controls using ultrasound, 30 it is important to remember that while supportive, the ultrasound findings are not specific to PCOS. Polycystic ovaries are present in 92% of women with idiopathic hirsutism, 87% of women with oligomenorrhea, 30–40% of women with amenorrhea, and 23% of women with regular cycles.…”

A Comparative Study on Quantitative Assessment of Blood Flow and Vascularization in Polycystic Ovary Syndrome Patients and Normal Women Using Three-Dimensional Power Doppler Ultrasonography

“…Although the implication of this finding in ovulation induction treatment is unknown, it may help to explain the excessive response often seen in women with PCOS when they are administered gonadotrophins [7]. The presence of an increased stromal Doppler signal in the PCOS group [8], compared with women with normal ovaries, supports the notion that PCOS is a primary disorder of the ovary.…”