阴道超声单侧卵巢检查对PCOS诊断准确性的影响

Influence of Transvaginal One-side Ovary Ultrasound Examination on Diagnostic Accuracy of Polycystic Ovary Syndrome

目的：探讨阴道超声仅单侧卵巢检查对多囊卵巢综合征（PCOS）诊断准确性的影响。方法：选择2013年6月至2014年10月阴道超声诊断PCOS患者79例（PCOS组）和同期43例正常对照病例（对照组），计算一致性相关系数（CCC），并对卵巢的窦卵泡计数（AFC）和卵巢体积（OV）进行Bland-Altman法分析。结果：Bland．Ahman分析显示，PCOS组左右侧卵巢的AFC和OV平均差分别为0．23（95％CI，-0．65～0．97）和1．68ml（95％CI，0．37～2．52），对照组分别为O．38（95％CI,-0．17～1．08）和0．63ml（95％CI，-0．42—1．55）。PCOS组AFC和OV-致性界限范围分别为-14．0～14．4和-15．7～19．1，对照组分别为-7．4～8．2和-8．0～9．2。PCOS组和对照组的左右两侧卵巢AFC和OV的CCC均〈0．9。22．8％患者仅单侧卵巢出现多囊卵巢形态（PCOM），同时约8．9％PCOS患者仅在单侧卵巢满足PCOM等两项诊断指标。结论：PCOS患者左右侧卵巢超声特征差异较大，阴道超声仅单侧卵巢检查可能会漏诊部分PCOS患者，建议尽可能采用双侧卵巢超声诊断以提高PCOS诊断的准确性。

Objective：To explore the diagnostic accuracy of transvaginal one-side ovary ultrasound examination on polycystic ovary syndrome（PCOS）. Methods： From June 2013 to October 2014,79 PCOS cases were enrolled in PCOS group, and 43 healthy controls were enrolled in control group. Concordance correlation coeffi- cient（CCC） was calculated and antral follicle count（AFC）and ovarian volumes（OV） were analyzed by Bland-ALtman method. Results： By Bland-Altman method for PCOS patients, the mean difference of AFC and OV was 0. 23（95% CI, -0. 65 -0.97） and 1.68 mL（95% CI,0.37 -2.52） respectively in PCOS group. In controls,it was 0.38 （95% CI, -0. 17 -1.08）and 0. 63 ml （95% CI, -0.42 -1.55）respectively. Consistency range of AFC and OV in PCOS group was -14.0 -14.4 and -15.7 -19. 1 ,respectively,and in control group,it was -7. 4 -8.2 and - 8.0 - 9.2, respectively. Bland-Altman analysis and CCC values indicated a poor concordance between right and left ovaries in PCOS patients and controls. 22. 8% PCOS patients showed polycystic ovarian morphology（PCOM） in only one ovary and PCOS diagnosis could be missed in about 8.9% of PCOS patients. Conclusions：This study showed the difference in AFC and OV between right and left ovary. One-side ovary ultrasound examination may lead to a missing diagnosis of some PCOS patients.