title: Ovarian morphology in polycystic ovary syndrome: estimates from 2D and 3D ultrasound and magnetic resonance imaging and their correlation to anti-Müllerian hormone.
abstract: Background Due to improved ultrasound scanners, new three-dimensional (3D) modalities, and novel Anti-Müllerian 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 1.25 mL (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.
authors.affiliation: 1 Department of Obstetrics and Gynecology, Herlev Gentofte Hospital, Herlev, Denmark.|2 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Malin
authors.initials: M
authors.lastname: Nylander
authors.affiliation: 2 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.|3 Department of Internal Medicine, Endocrine Unit, Herlev Gentofte Hospital, Herlev, Denmark.
authors.forename: Signe
authors.initials: S
authors.lastname: Frøssing
authors.affiliation: 1 Department of Obstetrics and Gynecology, Herlev Gentofte Hospital, Herlev, Denmark.
authors.forename: Anne H
authors.initials: AH
authors.lastname: Bjerre
authors.affiliation: 4 Department of Radiology, Herlev Gentofte Hospital, Denmark.
authors.forename: Elizaveta
authors.initials: E
authors.lastname: Chabanova
authors.affiliation: 1 Department of Obstetrics and Gynecology, Herlev Gentofte Hospital, Herlev, Denmark.|2 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Helle V
authors.initials: HV
authors.lastname: Clausen
authors.affiliation: 2 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.|3 Department of Internal Medicine, Endocrine Unit, Herlev Gentofte Hospital, Herlev, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
authors.affiliation: 1 Department of Obstetrics and Gynecology, Herlev Gentofte Hospital, Herlev, Denmark.|2 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Sven O
authors.initials: SO
authors.lastname: Skouby
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging; D050177:Overweight; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: 3D transvaginal ultrasound; Anti-Müllerian hormone; magnetic resonance imaging (MRI); polycystic ovaries; polycystic ovary syndrome (PCOS)