Diagnosis of polycystic ovaries by three-dimensional transvaginal ultrasound

• Published in: Fertility and sterility Vol. 85; no. 1; p. 214
• Main Authors: Allemand, Michael C, Tummon, Ian S, Phy, Jennifer L, Foong, Shu C, Dumesic, Daniel A, Session, Donna R
• Format: Journal Article
• Language: English
• Published: United States 01-01-2006
• Subjects: Adult; Female; Humans; Imaging, Three-Dimensional; Polycystic Ovary Syndrome - diagnostic imaging; Reproducibility of Results; Retrospective Studies; Ultrasonography - methods; Ultrasonography - standards; Vagina
• ISSN: 1556-5653
• DOI: 10.1016/j.fertnstert.2005.07.1279

To study diagnostic thresholds for polycystic ovary (PCO).
Retrospective cohort study.
Academic hospital.
Normoandrogenic ovulatory women and patients with polycystic ovary syndrome (PCOS).
Two-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound.
The mean follicle number per ovary (FNPO) of both ovaries and the maximum number follicles in a single sonographic plane (FSSP) of either ovary were determined using 3D transvaginal ultrasound. Ovarian volume was determined using 2D transvaginal ultrasound.
Twenty-nine normoandrogenic ovulatory women were compared with 10 patients with PCOS. Diagnostic thresholds for PCO with 100% specificity as determined by receiver operator characteristic (ROC) curves were > or =20 for mean FNPO, > or =10 for maximum FSSP, and > or =13 cm3 for ovarian volume. Both 2D and 3D transvaginal ultrasound were highly accurate in the diagnosis of PCO as determined by areas under the curve (AUC) that were >90% for all three measures.
Mean FNPO and maximum FSSP by 3D transvaginal ultrasound have comparable high accuracy for diagnosis of PCO. The diagnostic threshold with 100% specificity for mean FNPO is > or =20, which is greater than suggested by the Rotterdam Consensus Workshop in 2003. Use of the consensus standard, consequently, may result in overdiagnosis of PCO. A threshold of > or =20 mean FNPO using 3D transvaginal ultrasound may be appropriate to minimize false-positive diagnoses of PCO.