Polycystic ovary syndrome in perimenarchal obese adolescents: experience with magnetic resonance imaging

Abstract

Aim The aim of the study was to assess the diagnostic accuracy of pelvic ultrasound (PUS) and magnetic resonance imaging (PMRI) in detecting polycystic ovary syndrome (PCOS) in hyperandrogenic obese adolescent females with menarche age under 2 years compared with healthy females of the same age. Methods We studied 10 patients of mean age 14.63±1.26 years (±SD range: 12.3–16.2 years), of gynaecological age under 2 years, with clinical and biochemical hyperandrogenism. Other causes of hyperandrogenism were excluded. Out of 10 patients, seven had PUS suggestive of PCOS and three were doubtful. All patients had a body mass index over 95th centile and all underwent PUS and PMRI in early follicular phase (1st to 7th day of cycle). Nine healthy, non-obese girls of the same age formed the control group. Results Using PUS in the 10 patients with suspicion of PCOS, ovary volume was found to be <10 ml in seven and doubtful in three. In nine patients, less than 12 follicles were found. Using PMRI, ovary volume was >10 ml in all the patients except one in whom the volume was <10 ml; all the subjects had more than 12 follicles in the ovaries. In the control group (n = 9), the ovary volume was <10 ml using PUS and PMRI in all subjects but one who had a 10 ml volume. All the control subjects showed <12 follicles with either PUS or PMRI. Conclusion In adolescent girls with suspected PCOS, especially if obese, PMRI is a useful and accurate method for analysing ovary volume or structure alterations. Our data showed that PMRI may be a valid alternative for precocious diagnosis of PCOS in adolescents when PUS is negative or doubtful.