ULTRASOUND ASSESSMENT OF OVARIAN STROMA HYPERTROPHY IN HYPERANDROGENISM AND OVULATION DISORDERS - VISUAL ANALYSIS VERSUS COMPUTERIZED QUANTIFICATION

Objective: To extend our previous findings on the diagnostic validity of ovarian stroma hypertrophy in women with hyperandrogenic and/or men strual disorders. Design: Transvaginal ultrasonography was performed i n 69 patients complaining of hyperandrogenism and/or menstrual disorde rs and in 48 normal ovulatory women in early follicular phase. To chec k the validity of stroma assessment by visual analysis, we used comput er-assisted analysis, which allowed selective measurement of the strom al area on a longitudinal ovarian cut. Sensitivity and specificity of each method were estimated by using the normative data from the contro l group. Results: Stromal area was considered to be increased using vi sual analysis and computer assisted analysis in 74% and 61% patients, respectively. Specificity of this sign was 84% and 96% by visual analy sis and computer-assisted analysis, respectively. In patients, the inc rease in stromal area correlated very significantly with the one of to tal ovarian area, whose upper normal. limit was 5.5 cm(2) per ovary. C onclusion: Visual assessment of stroma may be misleading in some cases , with the risk of overestimating its hypertrophy. An increased total ovarian area >5.5 cm(2) (which can easily be detected by carefully sha ping a strict longitudinal ovarian cut) has the same diagnostic value as an increased stromal area by computerized measurement.