Division of Nutritional Sciences, Cornell University, Ithaca, New York.
Division of Nutritional Sciences, Cornell University, Ithaca, New York.
Fertil Steril. 2021 Mar;115(3):761-770. doi: 10.1016/j.fertnstert.2020.09.006. Epub 2021 Feb 20.
To determine the level of agreement across assessments of follicle number per ovary (FNPO) and classifying of polycystic ovarian morphology (PCOM; FNPO ≥25) with the use of various real-time (RT) and off-line two-dimensional (2D) and three-dimensional (3D) ultrasonographic methods.
Method comparison study.
University-based clinical research unit.
PATIENT(S): Sixteen women with and without PCOM.
Thirty-two ovaries were analyzed with the use of eight ultrasonographic methods: 2D-Grid (reference method), 2D-RT, 2D-RT with Grid, multiplanar view (MPV), MPV-RT, tomographic ultrasound imaging (TUI), TUI-RT, and semiautomated volume calculation (SonoAVC).
MAIN OUTCOME MEASURE(S): FNPO, PCOM status, and time to obtain FNPO. Clinical feasibility, defined as the time taken to obtain FNPO, also was evaluated.
RESULT(S): 2D-RT overestimated FNPO versus 2D-Grid (3 ± 9 follicles) owing to overcounting in non-PCOM ovaries (6 ± 6 follicles). However, systematic bias was not detected when a grid overlay was incorporated (2D-RT with Grid). SonoAVC underestimated FNPO (-3 ± 5 follicles), particularly in PCOM ovaries (-4.1 ± 5.0 follicles). No bias in FNPO was detected between MPV, TUI, or TUI-RT versus 2D-Grid. 2D-RT significantly misclassified ovaries as PCOM. All methods except MPV took less time to complete FNPO assessments compared with 2D-Grid.
CONCLUSION(S): Variability in FNPO across ultrasonographic methods limits their interchangeable use, particularly when a precise metric is needed. 2D-RT may be problematic owing to its propensity to misclassify PCOM. 2D-RT with Grid and MPV-RT could represent clinically feasible alternatives to obtain FNPO and classify PCOM. Efforts to reduce variation in FNPO will clarify the relevance of PCOM in women's health.
确定使用各种实时（RT）和离线二维（2D）和三维（3D）超声方法评估每个卵巢的卵泡数（FNPO）和多囊卵巢形态分类（PCOM；FNPO≥25）的一致性水平。
方法比较研究。
大学临床研究单位。
16 名患有和不患有 PCOM 的女性。
使用 8 种超声方法分析 32 个卵巢：2D-Grid（参考方法）、2D-RT、2D-RT 加网格、多平面视图（MPV）、MPV-RT、断层超声成像（TUI）、TUI-RT 和半自动体积计算（SonoAVC）。
FNPO、PCOM 状态和获得 FNPO 的时间。还评估了临床可行性，定义为获得 FNPO 所需的时间。
2D-RT 相对于 2D-Grid 高估了 FNPO（3±9 个卵泡），因为在非 PCOM 卵巢中存在重复计数（6±6 个卵泡）。然而，当加入网格叠加时，未检测到系统偏差（2D-RT with Grid）。SonoAVC 低估了 FNPO（-3±5 个卵泡），尤其是在 PCOM 卵巢中（-4.1±5.0 个卵泡）。MPV、TUI 或 TUI-RT 与 2D-Grid 相比，FNPO 无偏差。2D-RT 显著错误地将卵巢分类为 PCOM。与 2D-Grid 相比，所有方法（除了 MPV）完成 FNPO 评估所需的时间都更少。
超声方法之间 FNPO 的可变性限制了它们的可互换使用，尤其是在需要精确测量时。由于 PCOM 倾向于分类错误，因此 2D-RT 可能存在问题。2D-RT with Grid 和 MPV-RT 可能是获得 FNPO 和分类 PCOM 的临床可行替代方法。减少 FNPO 变异性的努力将阐明 PCOM 在女性健康中的相关性。
