Shah Bina, Parnell Lauren, Milla Sarah, Kessler Marion, David Raphael
Department of Endocrinology, NYU School of Medicine, New York, New York 10016, USA.
J Pediatr Adolesc Gynecol. 2010 Jun;23(3):146-52. doi: 10.1016/j.jpag.2009.07.002. Epub 2009 Sep 3.
Our aim was to evaluate uterine and ovarian ultrasonographic features including endometrial thickness (ET) in adolescent females with PCOS, which is limited in this population.
We performed a retrospective chart review of young females (n=51) ranging in age from 10 to 18 years with the diagnosis of PCOS. Clinical, biochemical and pelvic sonography data were reviewed. Sonographic data included uterine parameters of ET, length, and volume as well as ovarian volume and follicular morphologic features.
Data in 51 girls were analyzed. Menstrual periods were reported as irregular in 26/51 (50.9%), amenorrheic in 19/51 (37.2%), regular in 4/51 (7.8%) and metrorrhagia in 2/51 (3.9%). Uterine features revealed that the endometrial stripe was enlarged (>7mm) in 16/51 (31.4%) of girls, all with homogeneous appearance. The uterine length was lower than normal in 22/51 (43.1%) of girls, normal in 21/51 (41.2%), and higher than normal in 8/51 (15.7%). Uterine volume was normal in 31/51 (60.7%) and higher in 20/51 (39.3%) of girls. Enlarged ovarian volume was found in 22/51 (43%) of patients. Mean ovarian volumes were 16.1cm(3) and 13.1cm(3) in bilateral and unilaterally enlarged ovaries, respectively. The morphology of ovarian follicles was studied in a subset of 40 patients. The location of ovarian follicles was peripheral in 81% and mixed in 19%. The number of follicles was also examined in 43 patients. They were few (<5) in 12%, moderate (5-10) in 5% and multiple (>10) in 84% cases. There was the presence of at least one >10mm cyst in 25% of girls.
Majority of the adolescents with PCOS demonstrated multiple peripheral ovarian follicles, with large ovarian volumes in some, indicating an important role of ultrasonography in the diagnosis of PCOS, even at a younger age. Endometrial thickness, uterine length, ovarian size, and follicular morphology should be carefully examined in cases of adolescent PCOS.
我们的目的是评估患有多囊卵巢综合征（PCOS）的青春期女性的子宫和卵巢超声特征，包括子宫内膜厚度（ET），这在该人群中的研究有限。
我们对51名年龄在10至18岁之间诊断为PCOS的年轻女性进行了回顾性病历审查。回顾了临床、生化和盆腔超声检查数据。超声检查数据包括ET、子宫长度和体积等子宫参数以及卵巢体积和卵泡形态特征。
分析了51名女孩的数据。据报告，26/51（50.9%）月经不规律，19/51（37.2%）闭经，4/51（7.8%）月经规律，2/51（3.9%）有子宫出血。子宫特征显示，16/51（31.4%）的女孩子宫内膜条带增宽（>7mm），均表现为均匀外观。22/51（43.1%）的女孩子宫长度低于正常，21/51（41.2%）正常，8/51（15.7%）高于正常。31/51（60.7%）的女孩子宫体积正常，20/51（39.3%）的女孩子宫体积增大。22/51（43%）的患者发现卵巢体积增大。双侧和单侧卵巢增大患者的平均卵巢体积分别为16.1cm³和13.1cm³。在40名患者的子集中研究了卵巢卵泡的形态。81%的卵巢卵泡位于周边，19%为混合性。还对43名患者的卵泡数量进行了检查。12%的病例卵泡数量少（<5个），5%为中等数量（5 - 10个），84%为多个（>10个）。25%的女孩至少有一个>10mm的囊肿。
大多数患有PCOS的青少年表现出多个周边卵巢卵泡，部分卵巢体积较大，这表明超声检查在PCOS诊断中具有重要作用，即使在较年轻的年龄。对于青春期PCOS病例，应仔细检查子宫内膜厚度、子宫长度、卵巢大小和卵泡形态。
