Ovarian morphology in polycystic ovary syndrome: estimates from 2D and 3D ultrasound and magnetic resonance imaging and their correlation to anti-Müllerian hormone

Malin Nylander, Signe Frøssing, Elizaveta Chabanova, Helle Vibeke Clausen, Jens Oscar Faber, Sven Olaf Skouby, Anne Bjerre

14 Citationer (Scopus)

Abstract

Background: Due to improved ultrasound scanners, new three-dimensional (3D) modalities, and novel Anti-Mu¨llerian hormone (AMH)-assays, the ultrasound criteria for polycystic ovarian morphology are under debate and the appropriate thresholds are often requested. Purpose: To quantify the differences in estimates of ovarian volume and antral follicle count (AFC) from two-dimensional (2D) and 3D transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI). Material and Methods: A cross-sectional study on 66 overweight women with polycystic ovary syndrome (PCOS) according to Rotterdam criteria. Ovarian volume and AFC were estimated from MRI, 2D TVUS, and 3D TVUS, and serum AMH levels were assessed. Bland–Altman statistics were used for comparison. Results: Participants had a median age of 29 years (age range, 19–44 years) with a mean BMI of 32.7 kg/m2 (SD 4.5). Ovarian volume from 2D TVUS was 1.48 mL (95% confidence interval [CI], 0.94–2.03; P<0.001) and 1.25mL (95% CI, 0.62–1.87; P<0.001) smaller than from 3D TVUS and MRI, respectively. AFC from 2D TVUS was 18% (95% CI, 13–23; P<0.005) and 16% (95% CI, 6–25; P<0.005) smaller than estimates from 3D TVUS and MRI, respectively. Correlations between AMH and AFC from 2D TVUS, 3D TVUS, and MRI were 0.67, 0.78, and 0.70, respectively (P<0.001 for all). Conclusion: In an overweight PCOS population, 2D TVUS underestimated ovarian volume and AFC as compared with 3D TVUS and MRI. Serum AMH correlated best with AFC from 3D TVUS, followed by MRI and 2D TVUS. The advantage of 3D TVUS might be of minor clinical importance when diagnosing PCOS, but useful when the actual AFC are of interest, e.g. in fertility counseling and research.
OriginalsprogEngelsk
TidsskriftActa Radiologica
Vol/bind58
Udgave nummer8
Sider (fra-til)997-1004
Antal sider8
ISSN0284-1851
StatusUdgivet - aug. 2017

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