Contribution of real-time elastography in diagnosis of polycystic ovary syndrome

Abstract

PURPOSEWe aimed to assess the feasibility and reproducibility of re-al-time elastography (RTE) for displaying the effects of mor-phological changes in the ovary in polycystic ovary syndrome (PCOS). METHODSForty-eight patients diagnosed with PCOS and 48 healthy women were enrolled in the study. Ultrasonography and RTE were performed on the 3rd day of the menstrual cycle. Eval-uations were performed independently by two radiologists. Ovarian volume, number of follicles, elasticity pattern, and strain ratio were measured. Elasticity patterns were assessed as hard (type 1; blue or blue-green), moderate (type 2; green or green-yellow) or soft (type 3; red or orange-red). RESULTSBoth radiologists determined the elasticity pattern as mostly type 1 in the PCOS group and type 3 in the control group (P < 0.01). The mean strain ratios obtained by the first and second radiologist were 6.1±1.8 (2.7-10.1) and 6.0±1.5 (3.0-9.0) in PCOS and 3.3±1.2 (1.7-7.2) and 3.2±0.9 (1.7-6.8) in the control group, respectively (P < 0.001). Interob-server agreement was moderate for the elasticity pattern (?=0.48) and good for the strain ratio (intraclass correlation coefficient, 0.77). A strain ratio of 3.8 was determined as the optimized cutoff point by receiver operating curve analysis. Strain ratio was correlated with the ovarian volume and the number of detected follicles (P < 0.001). CONCLUSIONElasticity pattern and strain ratio can help identify morpho-logical changes that make PCOS ovaries stiffer than normal ovaries