Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls.
OBJECTIVE
To evaluate ovarian morphology using three-dimensional magnetic resonance imaging (MRI) in adolescent girls with and without polycystic ovary syndrome (PCOS). Also compare the utility of MRI versus ultrasonography (US) for diagnosis of PCOS.


METHODS
Cross-sectional study.


METHODS
Urban academic tertiary-care children's hospital.


METHODS
Thirty-nine adolescent girls with untreated PCOS and 22 age/body mass index (BMI)-matched controls.


METHODS
Magnetic resonance imaging and/or transvaginal/transabdominal US.


METHODS
Ovarian volume (OV); follicle number per section (FNPS); correlation between OV on MRI and US; proportion of subjects with features of polycystic ovaries (PCOs) on MRI and US.


RESULTS
Magnetic resonance imaging demonstrated larger OV and higher FNPS in subjects with PCOS compared with controls. Within the PCOS group, median OV was 11.9 (7.7) cm(3) by MRI compared with 8.8 (7.8) cm(3) by US. Correlation coefficient between OV by MRI and US was 0.701. Due to poor resolution, FNPS could not be determined by US or compared with MRI. The receiver operating characteristic curve analysis for MRI demonstrated that increasing volume cutoffs for PCOs from 10-14 cm(3) increased specificity from 77%-95%. For FNPS on MRI, specificity increased from 82%-98% by increasing cutoffs from ≥ 12 to ≥ 17. Using Rotterdam cutoffs, 91% of subjects with PCOS met PCO criteria on MRI, whereas only 52% met criteria by US.


CONCLUSIONS
Ultrasonography measures smaller OV than MRI, cannot accurately detect follicle number, and is a poor imaging modality for characterizing PCOs in adolescents with suspected PCOS. For adolescents in whom diagnosis of PCOS remains uncertain after clinical and laboratory evaluation, MRI should be considered as a diagnostic imaging modality.
Division of Pediatric Endocrinology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Lisa E
LE
Kenigsberg
Division of Pediatric Endocrinology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Chhavi
C
Agarwal
Division of Respiratory and Sleep Medicine, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Sanghun
S
Sin
Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
Keivan
K
Shifteh
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
Carmen R
CR
Isasi
Division of Pediatric Endocrinology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Rebecca
R
Crespi
Division of Respiratory and Sleep Medicine, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Janeta
J
Ivanova
Division of Adolescent Medicine, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Susan M
SM
Coupey
Division of Pediatric Endocrinology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Rubina A
RA
Heptulla
Division of Respiratory and Sleep Medicine, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York. Electronic address: rarens@montefiore.org.
Raanan
R
Arens
D000293:Adolescent; D000367:Age Factors; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008279:Magnetic Resonance Imaging; D009929:Organ Size; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000473:pathology; D010053:Ovary / Q000000981:diagnostic imaging* / Q000473:pathology*; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D062606:Tertiary Care Centers; D014463:Ultrasonography
MRI; PCOS; adolescent; ovarian imaging