Ach Taieb, Guesmi Ayoub, Kalboussi Maha, Ben Abdessalem Fatma, Mraihi Emna, El Mhabrech Houda
Departments of Endocrinology, University Hospital of Farhat Hached, Postal Box 268, Khezama Ouest, Sousse 4071, Tunisia.
Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.
Ther Adv Reprod Health. 2024 Aug 20;18:26334941241270372. doi: 10.1177/26334941241270372. eCollection 2024 Jan-Dec.
Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrinopathies among young women. Ultrasound evidence of polycystic ovaries is one of its crucial diagnostic criteria.
Our main objective is to study the contribution of ultrasound data in diagnosing PCOS. In addition, we aim to establish a new cutoff point for the use of ultrasound and to determine its sensitivity as well as its specificity.
It was a prospective study, including all patients presenting with clinical hyperandrogenism.
The ultrasound examination of these patients was performed using a novel ultrasound machine (18 MHz) compared to an older ultrasound machine (2 Hz-8 MHz). Inclusion criteria encompassed adult female patients over 18 years presenting symptoms suggestive of PCOS, particularly hyperandrogenism and oligo-anovulation, meeting Rotterdam's diagnostic criteria. Prior to inclusion, assessments were conducted to eliminate other potential causes explaining hyperandrogenism or menstrual disorders in both groups.
We examined 92 patients diagnosed with PCOS. Menstrual disorders were the main symptoms, with amenorrhea being more frequent in the PCOS group (G1) (48.9% vs the control group (G2): 11.1%). The follicle number was significantly lower in the control group, as assessed by both ultrasound machines ( < 10). The accuracy of the new ultrasound device was evaluated compared to the old one using the receiver operating characteristic (ROC) curve, revealing a cutoff of 18 follicles (sensitivity of 68.1%, specificity of 100%) and an area under the curve of 0.955. We found a significant difference between the median values of the number of follicles (NF) by both ultrasound machines (18 vs 12). It was positively correlated with an index of r = 0.916. For the volume, it was distinctively higher in G1 ( < 10). ROC curve analysis revealed an ovarian volume cutoff of 9.25 ml with a sensitivity of 48.9% and a specificity of 100%. Both ultrasound machines were positively correlated with an index of r = 0.979 ( < 10).
In conclusion, we were able to establish significant correlations between the new and the old ultrasound devices for both the NF and ovarian volume. Our study is distinctive as it represents the first on the African continent to re-evaluate the ultrasound criterion for PCOS.
多囊卵巢综合征（PCOS）是年轻女性中最常见的内分泌疾病之一。多囊卵巢的超声证据是其关键诊断标准之一。
我们的主要目的是研究超声数据在诊断PCOS中的作用。此外，我们旨在建立一个新的超声诊断切点，并确定其敏感性和特异性。
这是一项前瞻性研究，纳入所有表现为临床高雄激素血症的患者。
与一台较旧的超声设备（2Hz - 8MHz）相比，使用一台新型超声设备（18MHz）对这些患者进行超声检查。纳入标准包括年龄超过18岁、出现提示PCOS症状（特别是高雄激素血症和少排卵或无排卵）且符合鹿特丹诊断标准的成年女性患者。在纳入之前，对两组患者进行评估以排除其他可能解释高雄激素血症或月经紊乱的潜在原因。
我们检查了92例诊断为PCOS的患者。月经紊乱是主要症状，PCOS组（G1）闭经更为常见（48.9%，而对照组（G2）为11.1%）。两台超声设备评估显示，对照组的卵泡数量明显更少（<10个）。使用受试者工作特征（ROC）曲线将新型超声设备与旧设备进行比较，评估其准确性，结果显示切点为18个卵泡（敏感性为68.1%，特异性为100%），曲线下面积为0.955。我们发现两台超声设备测得的卵泡数量（NF）中位数之间存在显著差异（18个对12个），二者呈正相关，相关系数r = 0.916。对于体积，G1组明显更高（<10）。ROC曲线分析显示卵巢体积切点为9.25ml，敏感性为48.9%，特异性为100%。两台超声设备在体积测量上呈正相关，相关系数r = 0.979（<10）。
总之，我们能够确定新型和旧型超声设备在卵泡数量和卵巢体积方面存在显著相关性。我们的研究具有独特性，因为它是非洲大陆首次重新评估PCOS超声诊断标准的研究。
