Ovarian imaging by magnetic resonance in adolescent girls with polycystic ovary syndrome and age‐matched controls

Abstract

Purpose To compare ovarian morphology in adolescent girls with and without polycystic ovary syndrome (PCOS) using magnetic resonance (MR) imaging. Materials and Methods In 21 adolescent girls (12–18 years) without and 19 adolescents with PCOS (diagnosis based on excessive hair growth and irregular menstrual cycles) ovarian volume, antral follicle count (AFC) per ovary, and follicle size were evaluated. MR imaging was performed at 1.5 T or 3 T and axial or angled-axial single-shot echo-train spin echo images of 6 mm slice thickness were acquired. In a subset of subjects, 2 mm images were also obtained. PCOS and non-PCOS groups were compared using mixed affects regression. Results Mean AFC per ovary and ovarian volume were substantially greater in PCOS subjects compared to non-PCOS subjects. Mean follicle size was similar between groups. Follicles exceeding 10 mm were seen in 2/19 PCOS subjects versus 9/21 non-PCOS subjects. Consistently higher follicle counts were detected in images obtained at 2 mm compared to 6 mm slice thickness. Conclusion In adolescence MR imaging of the ovary reveals distinct differences between girls with and without PCOS. MR imaging may help evaluate young patients in whom transvaginal ultrasound is contraindicated.

Anti-Mullerian hormone may be a useful adjunct in the diagnosis of polycystic ovary syndrome in nonobese adolescents

“…The accepted definition of PCO is based on transvaginal ultrasound in adults and may not be applicable to adolescents (6) since transabdominal ultrasound is generally used in adolescents and ovarian size may be smaller in affected adolescents with PCOS than in affected adults (7). …”

The Diagnosis of Polycystic Ovary Syndrome during Adolescence

“…Follicle number and size are also noted to increase with puberty, with a higher number of small follicles during adolescence and young adulthood and a decrease thereafter [84] . Isolated studies have also suggested the use of MRI or Doppler examination for the diagnosis of PCOM [85][86][87][88] . Dewailly et al [79] concluded that, when using transabdominal ultrasonography, an ovarian volume >10 cm 3 should be used because follicle counts become unreliable with this methodology.…”

The Polycystic Ovary Morphology-Polycystic Ovary Syndrome Spectrum

“…Diverse criteria have been used for defining PCOM in adolescents, 52,56,64–70 which has contributed to widely different estimates of PCOM prevalence in adolescents. It is now clear that current adult PCOM criteria are exceeded in about one-third of normal adolescents.…”

“…52,64,66–68 Furthermore, several studies indicate that ovarian volume during adolescence is larger than that of the normal adult: for example, the median for the normal upper limit of mean ovarian volume during adolescence according to studies to date approximates 12 cc (Table 5). 52,56,66–70,72,73 Thus, application of adult criteria for PCOM to adolescents seems very problematic.…”