Polycystic ovary syndrome ultrasound
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
The Rotterdam 2003 criteria include the use of ultrasound as a diagnostic tool in diagnosing PCOS. The typical polycystic-appearing ovary may emerge in a nonspecific fashion on an ultrasound. Multiple (12+) subcapsular follicles ranging from 2 to 9 mm in diameter in a state of arrested development ('pearl necklace' appearance) in a single ovary is diagnostic for PCOS on ultrasound.
Ultrasound
Typical ultrasonography findings in patients with PCOS are as follows:[1]
- Two- to 5-fold ovarian enlargement; ovarian volume >10 cm3
- Thickened stroma (tunica albuginea)
- Thecal hyperplasia with an increase in stromal content
- Multiple (12+) subcapsular follicles ranging from 2 to 9 mm in diameter in a state of arrested development ('pearl necklace' appearance).
- A discrete androgen-producing tumor in the ovary may be present in 5% or fewer patients
- The endometrium may be hyperplastic despite low estrogen production by the follicles; this is probably due to high estrone production from the increased circulating androgens and lack of opposition by progesterone
- Clomiphene may alter results due to ovarian stimulation, resulting in multiple ovarian cysts
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References
- ↑ Kenigsberg LE, Agarwal C, Sin S, Shifteh K, Isasi CR, Crespi R, Ivanova J, Coupey SM, Heptulla RA, Arens R (2015). "Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls". Fertil. Steril. 104 (5): 1302–9.e1–4. doi:10.1016/j.fertnstert.2015.08.002. PMC 4630153. PMID 26354095.