A new ultrasound criterion for the diagnosis of polycystic ovary syndrome:the ovarian stroma/total area ratio

Objective: To evaluate whether some ultrasound parameters of ovarian morpho logy can discriminate between control women and patients with polycystic ov ary syndrome (PCOS). Design: Retrospective data analysis. Setting: Volunteers women in an academic research environment. Patient(s): Eighty amenorrheic or oligomenorrheic women and 30 normal ovula tory control participants. Intervention(s): None. Main Outcome Measure(s): We evaluated ovarian volume, area, stroma, and the stroma/total area (SIA) ratio by use of transvaginal pelvic ultrasound; an d we assayed serum levels of gonadotropin, androgen, and estradiol during t he early follicular phase (days 2 to 5) of the menstrual cycle in regularly cycling controls and on a random day in amenorrheic patients. Result(s): Patients with PCOS showed significantly higher ovarian volume, a rea, stroma, and mean S/A ratio when compared to multifollicular and contro l groups. Cut-off values have been defined for ovarian volume (13.21 mL), a rea (7.00 cm(2)), stroma. (1.95 cm(2)), and S/A ratio (0.34). The sensitivi ty for PCOS diagnosis was 21%, 4%, 62%, and 100%, respectively. The S/A rat io showed the most significant correlation with the androgen levels. Conclusion(s): The evaluation of the SIA ratio can differentiate between PC OS and control or multifollicular Za women with both a sensitivity and a sp ecificity of 100%. Furthermore, this ultrasound parameter is strictly relat ed to hormonal milieu and to anthropometric characteristics. (C) 2001 by Am erican Society for Reproductive Medicine.