Comparison of Two and Three-Dimensional Ultrasound in the Diagnosis of Polycystic Ovary Morphology: A Cross Sectional Study in Unselected Women

Comparison of Two and Three Dimensional Ultrasound in The Diagnosis of Polycystic Ovary Morphology

Abstract

Objective: To compare the visual appearance of the ovaries with two dimensional and three dimensional (3D) ultrasound (US) modalities in unselected women of reproductive age and to evaluate whether 3D changes the likelihood of polycystic ovary syndrome (PCOS) diagnosis.
Methods: This cross-sectional study was conducted in patients diagnosed within an unselected population of women (n = 115). The primary outcome measures were antral follicle count (AFC) and ovarian volume (OV), assessed using two different sonographic modalities. The agreement of these two sonographic modalities was tested using a Bland–Altman plot.
Results: Whereas the mean AFC with both sonographic modalities was 10.3 ± 4.8 vs. 11.2 ± 5.5 (p = 0.61), the OV estimated were 7.5 ± 3.0 vs. 9.6 ± 4.0 (p < 0.001) mL respectively. The mean bias, representing the upper and lower limits of agreement between the modalities for estimation of AFC, was – 0.17 (-8.45 to 8.11). The respective figure for OV was -1.99 mL (-7.72 to 3.75). Therefore, 3D revealed OV values that were 22.5% larger and identified 2 additional cases of PCOS according to the Rotterdam criteria.
Conclusion: 3D US yields larger OV values and classifies slightly more women as having PCOS. Although concerns related to the diagnosis of PCOM mainly focus on AFC, those findings also underscore the reliability of OV as a diagnostic parameter for the syndrome. These findings suggest that the imaging modality should be considered when interpreting ovarian measurements and applying diagnostic criteria.