Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls Lisa E. Kenigsberg,

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Presentation transcript:

Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls Lisa E. Kenigsberg, M.D., Chhavi Agarwal, M.D., Sanghun Sin, M.S., Keivan Shifteh, M.D., Carmen R. Isasi, M.D., Ph.D., Rebecca Crespi, N.P., Janeta Ivanova, Susan M. Coupey, M.D., Rubina A. Heptulla, M.D., Raanan Arens, M.D. Fertility and Sterility Volume 104, Issue 5, Pages 1302-1309.e4 (November 2015) DOI: 10.1016/j.fertnstert.2015.08.002 Copyright © 2015 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Ovarian morphology. (A) Magnetic resonance imaging; (B) transvaginal ultrasound; (C) transabdominal ultrasound. (A) Coronal view by magnetic resonance imaging of an ovary in an adolescent subject with polycystic ovary syndrome (PCOS). Follicles (hyperintense) are clearly demarcated from stroma (hypointense). (B and C) Ultrasound images from adolescent subjects with PCOS; (B) transvaginal image; (C) transabdominal image. Follicles are visualized in black (hypoechoic) with stroma appearing more hyperechoic. Distinguishing individual follicles by ultrasound is difficult, precluding a follicle count. Fertility and Sterility 2015 104, 1302-1309.e4DOI: (10.1016/j.fertnstert.2015.08.002) Copyright © 2015 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Range of ovarian volume and follicle number per section by magnetic resonance imaging in adolescents with polycystic ovary syndrome (PCOS) versus controls without PCOS. (A) Distribution of ovarian volume in subjects with PCOS and controls. The vertical dashed line delineates polycystic ovarian volume (>10 cm3) from normal ovarian volume (≤10 cm3) as per Rotterdam criteria and the solid line delineates polycystic ovarian volume (>14 cm3) from normal ovarian volume (≤14 cm3) as per the cutoff calculated in the present study. (B) Distribution of follicle number per section in subjects with PCOS and controls. The vertical dashed line delineates follicle number per section characterizing a polycystic ovary (PCO) (≥12) versus normal (<12) per Rotterdam criteria, the dash/dot line per Lujan et al. criteria, and the solid line per the cutoff calculated in the present study: PCO (≥17) versus normal (<17). Fertility and Sterility 2015 104, 1302-1309.e4DOI: (10.1016/j.fertnstert.2015.08.002) Copyright © 2015 American Society for Reproductive Medicine Terms and Conditions

Supplemental Figure 1 Correlation of magnetic resonance imaging (MRI) and ultrasound (US) ovarian volume by Bland Altman agreement analysis, used to analyze the agreement between the two imaging modalities. Ovarian volume on magnetic resonance imaging is highly correlated with ovarian volume by ultrasound, with a concordance correlation coefficient of 0.701 (P<.001). Fertility and Sterility 2015 104, 1302-1309.e4DOI: (10.1016/j.fertnstert.2015.08.002) Copyright © 2015 American Society for Reproductive Medicine Terms and Conditions

Supplemental Figure 2 Receiver operating characteristic (ROC) curve analysis for ovarian volume (A) and follicle number per section (B) by magnetic resonance imaging in adolescents with and without polycystic ovary syndrome (PCOS). The ROC area under the curve was 0.82 for ovarian volume and 0.80 for follicle number per section. Fertility and Sterility 2015 104, 1302-1309.e4DOI: (10.1016/j.fertnstert.2015.08.002) Copyright © 2015 American Society for Reproductive Medicine Terms and Conditions