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European Radiology

, Volume 20, Issue 5, pp 1207–1213 | Cite as

Patterns of ovarian morphology in polycystic ovary syndrome: a study utilising magnetic resonance imaging

  • Thomas M. Barber
  • Christopher Alvey
  • Tessa Greenslade
  • Mark Gooding
  • Debbie Barber
  • Rachel Smith
  • Anne Marland
  • John A. H. Wass
  • Tim Child
  • Mark I. McCarthy
  • Stephen Franks
  • Stephen J. Golding
Magnetic Resonance

Abstract

Objective

To evaluate and compare MRI-based ovarian morphology in groups of women with polycystic ovary syndrome (PCOS) and controls.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Polycystic ovary syndrome Magnetic resonance imaging Ovarian morphology Endocrinology Ovary 

Notes

Acknowledgements

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.

References

  1. 1.
    Barber TM, McCarthy MI, Wass JA, Franks S (2006) Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf) 65:137–145CrossRefGoogle Scholar
  2. 2.
    Zawadzki J, Dunaif A (1992) Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif AGJ, Haseltine FP, Merriam GR (eds) Polycystic ovary syndrome. Blackwell Scientific, Boston, pp 377–384Google Scholar
  3. 3.
    The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 19:41–47CrossRefGoogle Scholar
  4. 4.
    Balen AH, Laven JS, Tan SL, Dewailly D (2003) Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update 9:505–514CrossRefPubMedGoogle Scholar
  5. 5.
    Imaoka I, Wada A, Matsuo M, Yoshida M, Kitagaki H, Sugimura K (2003) MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics 23:1401–1421CrossRefPubMedGoogle Scholar
  6. 6.
    Mitchell DG, Gefter WB, Spritzer CE, Blasco L, Nulson J, Livolsi V, Axel L, Arger PH, Kressel HY (1986) Polycystic ovaries: MR imaging. Radiology 160:425–429PubMedGoogle Scholar
  7. 7.
    Yoo RY, Sirlin CB, Gottschalk M, Chang RJ (2005) Ovarian imaging by magnetic resonance in obese adolescent girls with polycystic ovary syndrome: a pilot study. Fertil Steril 84:985–995CrossRefPubMedGoogle Scholar
  8. 8.
    Faure N, Prat X, Bastide A, Lemay A (1989) Assessment of ovaries by magnetic resonance imaging in patients presenting with polycystic ovarian syndrome. Hum Reprod 4:468–472PubMedGoogle Scholar
  9. 9.
    Polson DW, Adams J, Wadsworth J, Franks S (1988) Polycystic ovaries—a common finding in normal women. Lancet 1:870–872CrossRefPubMedGoogle Scholar
  10. 10.
    The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25Google Scholar
  11. 11.
    Adams J, Polson DW, Franks S (1986) Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. Br Med J (Clin Res Ed) 293:355–359CrossRefGoogle Scholar
  12. 12.
    Ayida G, Chamberlain P, Barlow D, Koninckx P, Golding S, Kennedy S (1997) Is routine diagnostic laparoscopy for infertility still justified? A pilot study assessing the use of hysterosalpingo-contrast sonography and magnetic resonance imaging. Hum Reprod 12:1436–1439CrossRefPubMedGoogle Scholar
  13. 13.
    Adams JM, Taylor AE, Crowley WF Jr, Hall JE (2004) Polycystic ovarian morphology with regular ovulatory cycles: insights into the pathophysiology of polycystic ovarian syndrome. J Clin Endocrinol Metab 89:4343–4350CrossRefPubMedGoogle Scholar
  14. 14.
    Franks S (1989) Polycystic ovary syndrome: a changing perspective. Clin Endocrinol (Oxf) 31:87–120CrossRefGoogle Scholar
  15. 15.
    Swanson M, Sauerbrei EE, Cooperberg PL (1981) Medical implications of ultrasonically detected polycystic ovaries. J Clin Ultrasound 9:219–222CrossRefPubMedGoogle Scholar
  16. 16.
    Hauth EA, Umutlu L, Libera H, Kimmig R, Forsting M (2009) Magnetic resonance imaging of the pelvis in patients with polycystic ovary syndrome. Rofo 181:543–548PubMedGoogle Scholar
  17. 17.
    Lam PM, Raine-Fenning N (2006) The role of three-dimensional ultrasonography in polycystic ovary syndrome. Hum Reprod 21:2209–2215CrossRefPubMedGoogle Scholar
  18. 18.
    Lam PM, Johnson IR, Raine-Fenning NJ (2007) Three-dimensional ultrasound features of the polycystic ovary and the effect of different phenotypic expressions on these parameters. Hum Reprod 22:3116–3123CrossRefPubMedGoogle Scholar
  19. 19.
    Hahn S, Bering van Halteren W, Roesler S, Schmidt M, Kimmig R, Tan S, Mann K, Janssen OE (2006) The combination of increased ovarian volume and follicle number is associated with more severe hyperandrogenism in German women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes 114:175–181CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Thomas M. Barber
    • 1
  • Christopher Alvey
    • 3
  • Tessa Greenslade
    • 4
  • Mark Gooding
    • 5
  • Debbie Barber
    • 6
  • Rachel Smith
    • 1
  • Anne Marland
    • 1
  • John A. H. Wass
    • 1
  • Tim Child
    • 6
  • Mark I. McCarthy
    • 2
  • Stephen Franks
    • 7
  • Stephen J. Golding
    • 3
    • 5
  1. 1.Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and MetabolismChurchill HospitalOxfordUK
  2. 2.Oxford Centre for Diabetes, Endocrinology and MetabolismChurchill HospitalOxfordUK
  3. 3.Oxford MRI CentreJohn Radcliffe HospitalOxfordUK
  4. 4.Department of MedicineJohn Radcliffe HospitalOxfordUK
  5. 5.Department of EngineeringUniversity of OxfordOxfordUK
  6. 6.Department of Obstetrics and GynaecologyJohn Radcliffe HospitalOxfordUK
  7. 7.Institute of Reproductive and Developmental BiologyImperial College (Hammersmith Campus)LondonUK

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