Polycystic ovarian disease: contribution of vaginal endosonography and reassessment of ultrasonic diagnosis.
OBJECTIVE
We evaluated the superiority of vaginal ultrasonography (US) on the abdominal US for the diagnosis of polycystic ovarian disease (PCOD).


METHODS
The US pattern of ovaries was prospectively investigated by abdominal US and, whenever possible, by vaginal US.


METHODS
Primary care, institutional.


METHODS
One hundred forty-four women in whom PCOD was suspected on endocrine grounds and 62 other patients presenting with primary hyperprolactinemia (n = 23) or hypothalamic anovulation (n = 39).


METHODS
Vaginal US allowed a better analysis of the ovarian stroma.


RESULTS
The external ovarian features of PCOD were observed by both routes in less than one third of the 144 patients with PCOD. The internal ovarian features of PCOD were much more frequently observed by vaginal US than by abdominal US (polycystic pattern: 66.7% versus 38.1%, P less than 0.05; increased ovarian stroma: 57.1% versus 4.8%, P less than 0.001). In the 62 patients without PCOD, US features of PCOD were observed in less than 10% of them, except for the uterine width/ovarian length ratio less than 1 and the polycystic pattern (abdominal US: 17% and 34%; vaginal US: 11% and 50%, respectively).


CONCLUSIONS
An increased ovarian stroma seems to be the most sensitive and specific US sign of PCOD, providing that it can be investigated by vaginal US.
Ardaens
Y
Y
Department of Radiology, Centre Hospitalier Regional de Lille, France.
Robert
Y
Y
Lemaitre
L
L
Fossati
P
P
Dewailly
D
D
D000005:Abdomen; D000236:Adenoma / Q000097:blood / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D005260:Female; D006628:Hirsutism / Q000209:etiology; D006801:Humans; D009839:Oligomenorrhea / Q000209:etiology; D010911:Pituitary Neoplasms / Q000097:blood / Q000175:diagnosis; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D011388:Prolactin / Q000097:blood; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography; D014621:Vagina
D013739:Testosterone; D011388:Prolactin