B超测量卵巢体积和卵泡数目在青春期多囊卵巢综合征诊断中的价值

Diagnostic value of ovarian morphology by ultrasonography in pubertal polycystic ovary syndrome

目的探讨 B 超测量卵巢体积和卵泡数目用于诊断青春期多囊卵巢综合征(PCOS)的价值。方法对66例青春期 PCOS 患者(病例组)和27例对照组少女,进行经直肠双侧卵巢 B 超检查,并计算卵巢体积和卵泡数目,比较两组测量值的均数,采用受试者工作曲线(ROC)分析比较卵巢各指标的诊断价值并确定诊断界值。结果病例组与对照组的平均卵巢体积(MOV)、较大卵巢体积(MaxOV)和平均卵泡数目(MFN)分别为(9.2±3.2)cm^3、(11.4±4.7)cm^3、(12.0±3.9)个和(4.9±1.7)cm^3、(6.1±2.5)cm^3、(6.6±2.4)个,分别比较,差异有统计学意义(P<0.01)。MOV、MaxOV 和 MFN 诊断青春期 PCOS 的 ROC 曲线下面积(AUC)分别是0.914、0.884和0.838,3者比较,差异均无统计学意义(P>0.05)。MOV≥6.4 cm^3(敏感度84.8%,特异度87.5%)、MaxOV≥8.6 cm^3(敏感度75.8%,特异度95.2%)或 MFN≥8个(敏感度86.7%,特异度78.3%)分别是 B 超诊断青春期 PCOS 的较好界值。结论 B 超检测卵巢体积和卵泡数目对于青春期 PCOS 具有较好的诊断价值。以 MaxOV≥8.6 cm^3、MOV≥6.4 cm^3或 MFN≥8个作为界定青春期 PCOS 的 B 超标准,可获得较好的敏感度和特异度的平衡。

Objective To explore the ovarian morphological characteristics by uhrasonography as diagnostic criteria for pubertal polycystic ovary syndrome （PCOS）. Methods Sixty-six adolescent PCOS patients and 27 controls were involved in this study. They underwent transrectal ultrasound during the early follicular phase or amenorrheal period （dominant follicle excluded by ultrasonography）, t test and receiver operating characteristic （ROC） curve analysis were mainly used for statistical analysis. Results The mean ovarian volume （MOV）, maximal ovarian volume （MaxOV） and mean follicle number （MFN） in PCOS group were all significantly greater than control group （ P = 0. 000）. ROC curve analysis showed a satisfactory diagnostic potency for both ovarian volume and follicle number. The area under the ROC curve （AUC） was 0, 914, 0. 884 and 0. 838 for MOV, MaxOV and MFN respectively with no statistical difference among them （P 〉0. 05）. Setting the threshold of MOV at 6. 4 cm^3 offered the best compromise between sensitivity （84. 8% ） and specificity （87.5%）, and setting the threshold of MaxOV at 8. 6 cm^3 offered the best compromise between sensitivity （75.8%） and specificity （95.2%） and setting the threshold of MFN at 8 offered the best compromise between sensitivity （86. 7% ） and specificity （78.3%）. Conclusions Ovarian morphology by ultrasonography yields satisfactory diagnostic accuracy for adolescent PCOS. Taking MOV ≥ 6. 4 cm^3 or MaxOV ≥ 8.6 cm^3 or MFN ≥ 8 as an uhraphonic criterion for pubertal PCOS offer the best compromise between sensitivity and specificity.