The role of color doppler imaging in the diagnosis of polycystic ovary syndrome

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent disorder among premenopausal women, characterized by menstrual irregularities and infertility. It is associated with increased risks of obesity, diabetes, and cardiovascular diseases. The diagnosis of PCOS can be challenging due to its diverse symptoms. Transvaginal ultrasound with Doppler imaging is crucial for evaluating ovarian health without exposing patients to radiation.Objectives: This study aims to monitor ovarian vascular changes in PCOS patients and assess the impact of different treatment modalities. We evaluated changes in ovarian volume and blood flow parameters using transvaginal ultrasound with color Doppler.Methods: A hospital-based prospective observational study was conducted at M.G.M. Medical College and M.Y. Hospital in Indore, India. The study included ۱۰۶ clinically and biochemically diagnosed PCOS patients referred for pelvic ultrasound based on the Rotterdam criteria. Transvaginal sonography with color Doppler (۵-۷.۵ MHz) was utilized to assess ovarian parameters and Doppler flow in the ovarian artery. Follow-up imaging was performed three months post-treatment to compare changes in ultrasound parameters between two treatment groups: Group ۱ received oral contraceptive pills (OCPs), while Group ۲ underwent lifestyle and dietary modifications. Changes in imaging parameters were compared in both groups.Results: Both treatment groups exhibited a significant reduction in mean ovarian volume post-treatment, along with a notable increase in the resistance index (R.I.) and pulsatility index (P.I.) of the ovarian artery. Specifically, the right ovary's volume decreased by approximately ۴۵% (from ۱۳.۷۸ ml to ۷.۵۹ ml), while the left ovary's volume decreased by about ۳۶% (from ۱۱.۲۵ ml to ۷.۱۶ ml) following OCP treatment. Additionally, Doppler indices showed increases in R.I. and P.I., with the right ovarian artery R.I. rising from ۰.۵۷ to ۰.۷۹ and P.I. increasing from ۱.۳۲ to ۲.۱۰.Conclusions: According to current findings, transvaginal ultrasound with color Doppler imaging serves as an effective diagnostic tool when combined with clinical and biochemical findings for PCOS. Furthermore, the results indicated that OCPs led to more significant improvements in hormonal balance and ovarian characteristics compared to lifestyle modifications alone.

Keywords:

Polycystic ovary syndrome (PCOS) , Transvaginal sonography , pulsatility index (PI) and resistive index (RI)