Baş Hakan, Filiz Süleyman
Department of Radiology, Gazi Mustafa Kemal Occupational and Environmental Diseases Hospital, Silahtar Street No:6, Emniyet, Yenimahalle, Ankara 06560, Türkiye.
Department of Radiology, Faculty of Medicine, Ufuk University, Mevlana Boulevard No:86-88, Balgat Campus, Ankara 06520, Türkiye.
Diagnostics (Basel). 2025 May 29;15(11):1376. doi: 10.3390/diagnostics15111376.
This study aims to assess ovarian stromal vascularity using microvascular imaging in reproductive-aged women with polycystic ovarian morphology (PCOM) and to explore its associations with endocrine parameters and polycystic ovary syndrome (PCOS) phenotypes. We conducted a retrospective, single-center study between January 2021 and November 2023. Women aged 18-49 who met the PCOM criteria (≥20 follicles measuring 2-9 mm or an ovarian volume >10 cm in at least one ovary) were included. Pelvic ultrasound with MV-Flow Doppler imaging was used to quantify the stromal vascularity index (VI). On the same day, serum levels of FSH, LH, total and free testosterone, DHEAS, and estradiol were measured. PCOS phenotypes (A, C, D, and non-PCOS) were classified according to the Rotterdam criteria. Statistical analysis involved interobserver agreement using intraclass correlation coefficients (ICCs), correlation analysis for hormonal associations, and group comparisons using ANOVA. A total of 111 women (mean age: 27.4 ± 6.1 years) were evaluated. The mean VI was 43.88 ± 19.84, with good interobserver agreement (ICC = 0.79; 95% CI: 0.65-0.88). VI was highest in Phenotype A (61.36 ± 10.11), followed by Phenotype C (42.57 ± 3.59), Phenotype D (26.47 ± 4.24), and Non-PCOS individuals (9.95 ± 5.44; < 0.001). VI showed strong positive correlations with total testosterone (r = 0.797) and free testosterone (r = 0.778), and a moderate negative correlation with DHEAS (r = -0.483; < 0.001). Microvascular imaging is a promising tool for quantifying ovarian stromal vascularity in PCOM. Its strong correlation with androgen levels, especially in hyperandrogenic phenotypes, highlights its potential role in enhancing diagnostic precision and deepening our understanding of PCOS pathophysiology.
本研究旨在利用微血管成像评估多囊卵巢形态（PCOM）的育龄女性的卵巢基质血管情况，并探讨其与内分泌参数及多囊卵巢综合征（PCOS）表型的关联。我们在2021年1月至2023年11月期间进行了一项回顾性单中心研究。纳入了年龄在18 - 49岁且符合PCOM标准（至少一侧卵巢有≥20个直径2 - 9mm的卵泡或卵巢体积>10cm³）的女性。采用带有MV - Flow多普勒成像的盆腔超声来量化基质血管指数（VI）。在同一天，检测血清促卵泡生成素（FSH）、促黄体生成素（LH）、总睾酮和游离睾酮、硫酸脱氢表雄酮（DHEAS）以及雌二醇水平。根据鹿特丹标准对PCOS表型（A、C、D和非PCOS）进行分类。统计分析包括使用组内相关系数（ICC）进行观察者间一致性分析、对激素关联进行相关性分析以及使用方差分析进行组间比较。共评估了111名女性（平均年龄：27.4±6.1岁）。平均VI为43.88±19.84，观察者间一致性良好（ICC = 0.79；95%CI：0.65 - 0.88）。VI在表型A中最高（61.36±10.11），其次是表型C（42.57±3.59）、表型D（26.47±4.24）和非PCOS个体（9.95±5.44；P<0.001）。VI与总睾酮（r = 0.797）和游离睾酮（r = 0.778）呈强正相关，与DHEAS呈中度负相关（r = -0.483；P<0.001）。微血管成像对于量化PCOM中的卵巢基质血管是一种有前景的工具。其与雄激素水平的强相关性，尤其是在高雄激素表型中，凸显了其在提高诊断准确性和深化我们对PCOS病理生理学理解方面的潜在作用。
