Patterns of ovarian morphology in polycystic ovary syndrome: a study utilising magnetic resonance imaging
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To evaluate and compare MRI-based ovarian morphology in groups of women with polycystic ovary syndrome (PCOS) and controls.
All PCOS cases (n = 44) had oligo-amenorrhoea and hyperandrogenism irrespective of ovarian morphology, and fulfilled NIH/Rotterdam diagnostic criteria for PCOS. All control women (n = 40) had normal menses and normoandrogenaemia. All subjects were of white British/Irish origin and pre-menopausal. Group comparisons were based on independent-sample t tests. Polycystic ovarian morphology was defined by at least 12 follicles 2–9 mm in diameter and/or an ovarian volume greater than 10 cm3.
Ovarian morphology differed significantly in PCOS cases and controls (follicle number geometric mean [SD range] 18.6 [9.9, 35.0] vs 6.6 [3.1, 14.2], unadjusted P = 1.3 × 10−16; calculated ovarian volume 8.8 cm3 [5.0, 15.5] vs 5.1 cm3 [2.5, 10.3], unadjusted P = 3.0 × 10–7; peripheral follicle location in 55% vs 18% of ovaries, P = 7.9 × 10–6; visible central ovarian stroma in 61% vs 24% of ovaries, P = 2.3 × 10–5). Follicle number and calculated ovarian volume were not concordant with clinical/biochemical assignment of PCOS/control status in 36 (23%) and 52 (34%) of ovaries, respectively.
Ovarian morphology overlaps in PCOS cases and controls, emphasising the importance of considering clinical/biochemical presentation together with imaging ovarian morphology in the diagnosis of PCOS.
KeywordsPolycystic ovary syndrome Magnetic resonance imaging Ovarian morphology Endocrinology Ovary
We acknowledge the patients and nurses who contributed to the ascertainment of the various clinical samples used in this study. Research Fellowships were awarded by NovoNordisk (to TMB) and NIHR (to MG). We acknowledge the Fetal Medicine Unit at the John Radcliffe Hospital, Oxford for use of imaging facilities.
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