Utility of ultrasound in the diagnosis of polycystic ovary syndrome in adolescents

Capsule:
Polycystic ovary morphology according to the modified Rotterdam criteria in a nongynecologic cohort in our study is less common than previously reported. Transabdominal ultrasound may be a useful tool in the evaluation of polycystic ovary syndrome, even in obese adolescents.

Authors:
Michal Youngster, M.D., Valerie L. Ward, M.D., M.P.H., Emily A. Blood, Ph.D., Carol E. Barnewolt, M.D., Jean S. Emans, M.D., Amy D. Divasta, M.D.

Volume 102, Issue 5, Pages 1432–1438

Abstract:

Objective:
To determine the utility of transabdominal pelvic ultrasound in the diagnosis of polycystic ovary syndrome (PCOS) during adolescence.

Design:
Retrospective case-control study.

Setting:
Academic tertiary care pediatric hospital.

Patient(s):
A case group of 54 patients (mean age, 15.2 years) with PCOS based on the National Institutes of Health criteria and a comparison group of 98 patients (mean age, 14.6 years) with acute appendicitis.

Intervention(s):
Transabdominal ultrasound (TAUS) images were evaluated in the two groups of adolescents, with data collected on quality of the images, ovarian volume, ovarian follicle count, and endometrial thickness.

Main Outcome Measure(s):
Sonographic modified Rotterdam criteria (volume >10 mL and/or follicle number per section ≥10) for polycystic ovaries (PCO).

Result(s):
Among the 54 patients with PCOS and 98 comparison subjects with usable images, the sonographic modified Rotterdam criteria for PCO morphology (PCOM) were met more frequently in the PCOS group than in the comparison group (65% vs. 11%). The vast majority of images were of adequate quality for diagnosis (PCOS = 94% and comparison = 91%), even in the presence of obesity.

Conclusion(s):
The prevalence of ovarian morphology meeting the sonographic modified Rotterdam criteria by TAUS in girls with PCOS was markedly higher than in the adolescents serving as a comparison group. PCOM findings by the sonographic modified Rotterdam criteria were uncommon in the nongynecologic comparison group, in contrast to previous reports. TAUS may provide useful information in the evaluation of PCOS during adolescence, even in obese adolescents.

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