Nardo L G, Gelbaya T A
Department of Reproductive Medicine, Manchester Children University Hospitals NHS Trust, Manchester, UK.
Minerva Ginecol. 2008 Feb;60(1):83-9.
Polycystic ovary syndrome (PCOS) is a complex endocrinopathy, affecting 5-10% of women in the reproductive age group, with a wide spectrum of phenotypes. The cardinal features are hyperandrogenism, ovulatory dysfunction and/or polycystic ovary (PCO) appearance. Three major diagnostic criteria for PCOS have been proposed by the National Institute of Health (NIH 1990), the Rotterdam European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine sponsored PCOS Consensus Workshop Group (ESHRE/ASRM 2003) and the recent task force of the Androgen Excess Society (AES 2006). The PCO appearance is not a prerequisite for the diagnosis of PCOS. The aim of this review was to assess the available evidence in order to highlight the role of ultrasound in the diagnosis and management of PCOS. The evidence supports positive correlation between ultrasound features and biochemical indices of PCOS suggesting that ultrasound could play a role in prediction of PCOS severity and prognosis. Recent advances in ultrasonography resulted in a change of emphasis on the relative importance of total ovarian volume, follicle number and ovarian stromal changes in the diagnosis of PCO. In particular, ovarian stromal area/total area (S/A) ratio seems to have the most efficient diagnostic performance for hyperandrogenism. Three-dimensional (3D) ultrasound is a relatively new imaging modality that has the potential to improve the sensitivity and specificity of ultrasound without adding much to the practical management of the syndrome. In addition to its role in the definition of PCO, ultrasound is helpful to predict fertility outcome in patients undergoing treatment.
多囊卵巢综合征（PCOS）是一种复杂的内分泌病，影响着5%-10%的育龄妇女，具有广泛的表型。其主要特征是高雄激素血症、排卵功能障碍和/或多囊卵巢（PCO）表现。美国国立卫生研究院（NIH 1990）、鹿特丹欧洲人类生殖与胚胎学会/美国生殖医学学会赞助的PCOS共识研讨会小组（ESHRE/ASRM 2003）以及雄激素过多协会最近的特别工作组（AES 2006）提出了PCOS的三项主要诊断标准。PCO表现并非PCOS诊断的必要条件。本综述的目的是评估现有证据，以突出超声在PCOS诊断和管理中的作用。证据支持超声特征与PCOS生化指标之间存在正相关，这表明超声可在预测PCOS严重程度和预后方面发挥作用。超声检查的最新进展导致在PCO诊断中对卵巢总体积、卵泡数量和卵巢基质变化的相对重要性的侧重点发生了变化。特别是，卵巢基质面积/总面积（S/A）比值似乎对高雄激素血症具有最有效的诊断性能。三维（3D）超声是一种相对较新的成像方式，有可能提高超声的敏感性和特异性，而不会给该综合征的实际管理增加太多负担。除了在定义PCO方面的作用外，超声有助于预测接受治疗患者的生育结局。
