title: Diagnostic Usefulness of Transrectal Ultrasound Compared with Transvaginal Ultrasound Assessment in Young Korean Women with Polycystic Ovary Syndrome.
abstract: OBJECTIVE
  To determine the diagnostic performance of transrectal ultrasound in virgin patients with polycystic ovary syndrome (PCOS) by receiver operating characteristic (ROC) curve analysis, compared with conventional transvaginal ultrasound assessment.
  
  
  METHODS
  Ultrasound examinations were performed in 963 Korean women, with transvaginal transducers in 677 women and transrectal transducers in 286 women at Ewha Womans University Mokdong Hospital. Transvaginal ultrasound examinations were performed in 494 normal control women and 183 PCOS patients according to National Institutes of Health (NIH) PCOS diagnostic criteria. In virgin patients, transrectal ultrasound examinations were performed in 141 normal control women and 145 PCOS patients. ROC curves were calculated for ovarian volume and follicle number.
  
  
  RESULTS
  By transvaginal ultrasound examination, the ovarian volume showed an area under the ROC curve (AURC) of 0.838. An ovarian volume decision threshold > 7 cm(3) had a sensitivity of 73.0% and a specificity of 84.2% for the diagnosis of PCOS. The follicle number showed an AURC of 0.886. A follicle number decision threshold ≥ 9 had a sensitivity of 78.6% and a specificity of 87.2% for the diagnosis of PCOS. By transrectal ultrasound examination, the ovarian volume and the follicle number showed AURCs of 0.815 as same thresholds with a sensitivity of 67.2% and 66.4%, respectively and a specificity of 86.8% each. Ovarian volume and follicle number by transvaginal and transrectal ultrasound assessment had a high diagnostic power for PCOS screening.
  
  
  CONCLUSIONS
  Transrectal ultrasound assessment is as effective as conventional transvaginal ultrasound for the detection of PCOS in virgin patients.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Da Eun
authors.initials: DE
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: So Yun
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Sa Ra
authors.initials: SR
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Kyungah
authors.initials: K
authors.lastname: Jeong
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Chung
keywords: Polycystic ovary syndrome; Transrectal ultrasonography; Transvaginal ultrasonography