Balen Adam H, Laven Joop S E, Tan Seang-Lin, Dewailly Didier
Department of Reproductive Medicine, Leeds General Infirmary, Leeds, UK.
Hum Reprod Update. 2003 Nov-Dec;9(6):505-14. doi: 10.1093/humupd/dmg044.
The polycystic ovary syndrome (PCOS) is a heterogeneous condition, the pathophysiology of which appears to be both multifactorial and polygenic. The definition of the syndrome has been much debated. Key features include menstrual cycle disturbance, hyperandrogenism and obesity. There are many extra-ovarian aspects to the pathophysiology of PCOS, yet ovarian dysfunction is central. At a recent joint ASRM/ESHRE consensus meeting, a refined definition of the PCOS was agreed, encompassing a description of the morphology of the polycystic ovary (PCO). According to the available literature, the criteria fulfilling sufficient specificity and sensitivity to define the PCO should have at least one of the following: either 12 or more follicles measuring 2-9 mm in diameter, or increased ovarian volume (> 10 cm3). If there is a follicle > 10 mm in diameter, the scan should be repeated at a time of ovarian quiescence in order to calculate volume and area. The presence of a single PCO is sufficient to provide the diagnosis. The distribution of follicles and a description of the stroma are not required in the diagnosis. Increased stromal echogenicity and/or stromal volume are specific to PCO, but it has been shown that the measurement of ovarian volume (or area) is a good surrogate for quantification of the stroma in clinical practice. A woman having PCO in the absence of an ovulation disorder or hyperandrogenism ('asymptomatic PCO') should not be considered as having PCOS, until more is known about this situation. Three-dimensional and Doppler ultrasound studies may be useful research tools but are not required in the definition of PCO. This review outlines evidence for the current ultrasound definition of the polycystic ovary and technical specifications.
多囊卵巢综合征（PCOS）是一种异质性疾病，其病理生理学似乎是多因素和多基因的。该综合征的定义一直备受争议。关键特征包括月经周期紊乱、高雄激素血症和肥胖。PCOS的病理生理学有许多卵巢外方面，但卵巢功能障碍是核心。在最近一次美国生殖医学学会（ASRM）/欧洲人类生殖与胚胎学会（ESHRE）联合共识会议上，人们就PCOS的精确定义达成了一致，其中包括对多囊卵巢（PCO）形态的描述。根据现有文献，满足定义PCO足够特异性和敏感性的标准应至少具备以下一项：直径2 - 9毫米的卵泡12个或更多，或卵巢体积增加（> 10立方厘米）。如果有直径> 10毫米的卵泡，应在卵巢静止期重复扫描以计算体积和面积。单个PCO的存在足以做出诊断。诊断时不需要卵泡分布情况和间质描述。间质回声增强和/或间质体积增加是PCO特有的，但已表明在临床实践中测量卵巢体积（或面积）是量化间质的良好替代方法。在对这种情况了解更多之前，没有排卵障碍或高雄激素血症的患有PCO的女性（“无症状PCO”）不应被视为患有PCOS。三维和多普勒超声研究可能是有用的研究工具，但在PCO的定义中并非必需。本综述概述了当前多囊卵巢超声定义的证据和技术规范。
