Polycystic ovary syndrome ultrasound: Difference between revisions

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{{Polycystic ovary syndrome}}
{{Polycystic ovary syndrome}}
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==Overview==
==Overview==
The Rotterdam 2003 criteria include the use of [[ultrasound]] as a diagnostic tool in diagnosing polycystic ovary syndrome (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==
==Ultrasound==
===Ultrasonography===
Typical  [[ultrasonography]] findings in patients with PCOS are as follows:<ref name="pmid26354095">{{cite journal |vauthors=Kenigsberg LE, Agarwal C, Sin S, Shifteh K, Isasi CR, Crespi R, Ivanova J, Coupey SM, Heptulla RA, Arens R |title=Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls |journal=Fertil. Steril. |volume=104 |issue=5 |pages=1302–9.e1–4 |year=2015 |pmid=26354095 |pmc=4630153 |doi=10.1016/j.fertnstert.2015.08.002 |url=}}</ref><ref name="pmid26807298">{{cite journal |vauthors=Bachanek M, Abdalla N, Cendrowski K, Sawicki W |title=Value of ultrasonography in the diagnosis of polycystic ovary syndrome - literature review |journal=J Ultrason |volume=15 |issue=63 |pages=410–22 |year=2015 |pmid=26807298 |pmc=4710692 |doi=10.15557/JoU.2015.0038 |url=}}</ref><ref name="pmid23503943">{{cite journal |vauthors=Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR |title=Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume |journal=Hum. Reprod. |volume=28 |issue=5 |pages=1361–8 |year=2013 |pmid=23503943 |doi=10.1093/humrep/det062 |url=}}</ref>
Typical  ultrasonography findings in patients with PCOS are as follows:<ref name="pmid26354095">{{cite journal |vauthors=Kenigsberg LE, Agarwal C, Sin S, Shifteh K, Isasi CR, Crespi R, Ivanova J, Coupey SM, Heptulla RA, Arens R |title=Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls |journal=Fertil. Steril. |volume=104 |issue=5 |pages=1302–9.e1–4 |year=2015 |pmid=26354095 |pmc=4630153 |doi=10.1016/j.fertnstert.2015.08.002 |url=}}</ref>
*Two- to 5-fold [[ovarian]] enlargement; ovarian volume >10 cm<sup>3</sup>
*Two- to 5-fold ovarian enlargement; ovarian volume >10 cm3
*Thickened stroma ([[tunica albuginea]])
*Thickened stroma (tunica albuginea)
*Thecal hyperplasia with an increase in stromal content
*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); most are atretic and not necessarily cystic
*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
*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
*The endometrium may be hyperplastic despite low [[estrogen]] production by the follicles; this is probably due to high [[estrone]] production from the increased circulating [[Androgen|androgens]] and lack of opposition by [[progesterone]].
*Clomiphene may alter results due to ovarian stimulation, resulting in multiple ovarian cysts
*[[Clomiphene]] may alter results due to [[ovarian]] stimulation, resulting in multiple [[ovarian cysts]].
 
<gallery>
Image:Polycystic-ovarian-syndrome-001.jpg|Polycystic ovary syndrome
Image:Polycystic-ovarian-syndrome-002.jpg|Polycystic ovary syndrome
Image:Polycystic-ovarian-syndrome-003.jpg|Polycystic ovary syndrome
Image:Polycystic-ovarian-syndrome-004.jpg|Polycystic ovary syndrome
</gallery>
 
===Vaginal Ultrasound===
A '''vaginal ultrasound''' also might be used to examine the ovaries for [[cysts]] and check out the [[endometrium]], the lining of the [[uterus]]. The uterine lining may become thicker if your periods are not regular.


==References==
==References==

Latest revision as of 13:03, 2 November 2017

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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 polycystic ovary syndrome (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][2][3]

  • 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.

References

  1. 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.
  2. Bachanek M, Abdalla N, Cendrowski K, Sawicki W (2015). "Value of ultrasonography in the diagnosis of polycystic ovary syndrome - literature review". J Ultrason. 15 (63): 410–22. doi:10.15557/JoU.2015.0038. PMC 4710692. PMID 26807298.
  3. Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR (2013). "Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume". Hum. Reprod. 28 (5): 1361–8. doi:10.1093/humrep/det062. PMID 23503943.

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