A new ultrasound criterion for the diagnosis of polycystic ovary syndrome: the ovarian stroma/total area ratio.
OBJECTIVE
To evaluate whether some ultrasound parameters of ovarian morphology can discriminate between control women and patients with polycystic ovary syndrome (PCOS).


METHODS
Retrospective data analysis.


METHODS
Volunteers women in an academic research environment.


METHODS
Eighty amenorrheic or oligomenorrheic women and 30 normal ovulatory control participants.


METHODS
None.


METHODS
We evaluated ovarian volume, area, stroma, and the stroma/total area (S/A) ratio by use of transvaginal pelvic ultrasound; and we assayed serum levels of gonadotropin, androgen, and estradiol during the early follicular phase (days 2 to 5) of the menstrual cycle in regularly cycling controls and on a random day in amenorrheic patients.


RESULTS
Patients with PCOS showed significantly higher ovarian volume, area, stroma, and mean S/A ratio when compared to multifollicular and control groups. Cut-off values have been defined for ovarian volume (13.21 mL), area (7.00 cm2), stroma (1.95 cm2), and S/A ratio (0.34). The sensitivity for PCOS diagnosis was 21%, 4%, 62%, and 100%, respectively. The S/A ratio showed the most significant correlation with the androgen levels.


CONCLUSIONS
The evaluation of the S/A ratio can differentiate between PCOS and control or multifollicular women with both a sensitivity and a specificity of 100%. Furthermore, this ultrasound parameter is strictly related to hormonal milieu and to anthropometric characteristics.
Fulghesu
A M
AM
Department of Obstetrics and Gynecology, Universitá Cattolica del Sacro Cuore, Rome, Italy. fulgh@tiscalinet.it
Ciampelli
M
M
Belosi
C
C
Apa
R
R
Pavone
V
V
Lanzone
A
A
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000097:blood / Q000150:complications; D000735:Androstenedione / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D009839:Oligomenorrhea / Q000097:blood / Q000150:complications; D010053:Ovary / Q000000981:diagnostic imaging*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography
D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D000735:Androstenedione; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone