Complex heterogenous syndrome of ovulatory dysfunction, menstrual irregularity, and androgen excess
Rotterdam criteria for PCOS (2003): 2 of 3 criteria present
Ovulatory dysfunction
Hyperandrogenism (clinical or biochemical)
Polycystic ovarian morphology (PCOM) (by US)
PCOM → ovaries meeting criteria on US
PCOM: Preferred descriptor when seen on imaging
Can be seen in patients with anovulatory PCOS, milder phenotypes of PCOS, and even in women without evidence of metabolic syndrome
Isolated PCOM seen in up to 22-30% of normal females and not related to metabolic syndrome
Meaning of PCOM in asymptomatic population is currently unknown
Can represent mild spectrum of disease
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Dwivedi AND et al: Colour doppler evaluation of uterine and ovarian blood flow in patients of polycystic ovarian disease and post-treatment changes. Clin Radiol. 75(10):772-9, 2020
Expert Panel on Women's Imaging. et al: ACR Appropriateness Criteria® female infertility. J Am Coll Radiol. 17(5S):S113-24, 2020
Jarrett BY et al: Ultrasound characterization of disordered antral follicle development in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 105(11), 2020
Kostopoulou E et al: Polycystic ovary syndrome in adolescents: pitfalls in diagnosis and management. Curr Obes Rep. 9(3):193-203, 2020
Park CH et al: Influence of combined oral contraceptives on polycystic ovarian morphology-related parameters in Korean women with polycystic ovary syndrome. Obstet Gynecol Sci. 63(1):80-6, 2020
Peña AS et al: Adolescent polycystic ovary syndrome according to the international evidence-based guideline. BMC Med. 18(1):72, 2020
Azziz R et al: Recommendations for epidemiologic and phenotypic research in polycystic ovary syndrome: an androgen excess and PCOS society resource. Hum Reprod. 34(11):2254-65, 2019
Costello MF et al: Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility. Hum Reprod Open. 2019(1):hoy021, 2019
Dewailly D et al: Definition and significance of polycystic ovarian morphology: a task force report from the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update. 20(3):334-52, 2014
Lujan ME et al: Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume. Hum Reprod. 28(5):1361-8, 2013
Battaglia C et al: Two- and three-dimensional sonographic and color Doppler techniques for diagnosis of polycystic ovary syndrome. The stromal/ovarian volume ratio as a new diagnostic criterion. J Ultrasound Med. 31(7):1015-24, 2012
Catteau-Jonard S et al: Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome? Ultrasound Obstet Gynecol. 40(2):223-9, 2012
Lee TT et al: Polycystic ovarian syndrome: role of imaging in diagnosis. Radiographics. 32(6):1643-57, 2012
Dewailly D et al: Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod. 26(11):3123-9, 2011
Nardo LG et al: Evidence-based approach for the use of ultrasound in the management of polycystic ovary syndrome. Minerva Ginecol. 60(1):83-9, 2008
Porter MB: Polycystic ovary syndrome: the controversy of diagnosis by ultrasound. Semin Reprod Med. 26(3):241-51, 2008
Mahajan NN et al: Sonographic evaluation of the endometrium in patients with a history or an appearance of polycystic ovarian syndrome. J Ultrasound Med. 26(6):862; author reply 862, 2007
Complex heterogenous syndrome of ovulatory dysfunction, menstrual irregularity, and androgen excess
Rotterdam criteria for PCOS (2003): 2 of 3 criteria present
Ovulatory dysfunction
Hyperandrogenism (clinical or biochemical)
Polycystic ovarian morphology (PCOM) (by US)
PCOM → ovaries meeting criteria on US
PCOM: Preferred descriptor when seen on imaging
Can be seen in patients with anovulatory PCOS, milder phenotypes of PCOS, and even in women without evidence of metabolic syndrome
Isolated PCOM seen in up to 22-30% of normal females and not related to metabolic syndrome
Meaning of PCOM in asymptomatic population is currently unknown
Can represent mild spectrum of disease
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Dwivedi AND et al: Colour doppler evaluation of uterine and ovarian blood flow in patients of polycystic ovarian disease and post-treatment changes. Clin Radiol. 75(10):772-9, 2020
Expert Panel on Women's Imaging. et al: ACR Appropriateness Criteria® female infertility. J Am Coll Radiol. 17(5S):S113-24, 2020
Jarrett BY et al: Ultrasound characterization of disordered antral follicle development in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 105(11), 2020
Kostopoulou E et al: Polycystic ovary syndrome in adolescents: pitfalls in diagnosis and management. Curr Obes Rep. 9(3):193-203, 2020
Park CH et al: Influence of combined oral contraceptives on polycystic ovarian morphology-related parameters in Korean women with polycystic ovary syndrome. Obstet Gynecol Sci. 63(1):80-6, 2020
Peña AS et al: Adolescent polycystic ovary syndrome according to the international evidence-based guideline. BMC Med. 18(1):72, 2020
Azziz R et al: Recommendations for epidemiologic and phenotypic research in polycystic ovary syndrome: an androgen excess and PCOS society resource. Hum Reprod. 34(11):2254-65, 2019
Costello MF et al: Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility. Hum Reprod Open. 2019(1):hoy021, 2019
Dewailly D et al: Definition and significance of polycystic ovarian morphology: a task force report from the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update. 20(3):334-52, 2014
Lujan ME et al: Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume. Hum Reprod. 28(5):1361-8, 2013
Battaglia C et al: Two- and three-dimensional sonographic and color Doppler techniques for diagnosis of polycystic ovary syndrome. The stromal/ovarian volume ratio as a new diagnostic criterion. J Ultrasound Med. 31(7):1015-24, 2012
Catteau-Jonard S et al: Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome? Ultrasound Obstet Gynecol. 40(2):223-9, 2012
Lee TT et al: Polycystic ovarian syndrome: role of imaging in diagnosis. Radiographics. 32(6):1643-57, 2012
Dewailly D et al: Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod. 26(11):3123-9, 2011
Nardo LG et al: Evidence-based approach for the use of ultrasound in the management of polycystic ovary syndrome. Minerva Ginecol. 60(1):83-9, 2008
Porter MB: Polycystic ovary syndrome: the controversy of diagnosis by ultrasound. Semin Reprod Med. 26(3):241-51, 2008
Mahajan NN et al: Sonographic evaluation of the endometrium in patients with a history or an appearance of polycystic ovarian syndrome. J Ultrasound Med. 26(6):862; author reply 862, 2007
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