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Use of ultrasound biomicroscopy to image human ovaries in vitro
A Baerwald1, S Dauk, R Kanthan
1Department of Obstetrics, Gynecology and Reproductive Sciences, Royal University Hospital, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. angela.baerwald@usask.ca
Objectives:
To test the hypothesis that ultrasound biomicroscopy is an effective tool for imaging human ovaries in vitro.
Methods:
This was a prospective, observational study of 11 women (mean age, 48.9 +/- 2.3 years; range, 40-65 years) undergoing unilateral or bilateral oophorectomy. Ovaries were obtained in the operating room and imaged in a cooled saline bath using conventional two-dimensional (2D) ultrasound. Follicles identified using conventional 2D ultrasound were then imaged in a cooled saline bath using ultrasound biomicroscopy. Ovaries were then placed in 10% neutral-buffered formaldehyde and transported to the Pathology Department for histological evaluation. Digital images of individually identified ovarian follicles using conventional ultrasound, ultrasound biomicroscopy and histology were obtained (n = 22). Thicknesses of the follicle wall, granulosa layer and theca interna layer were measured using standardized techniques.
Results:
The imaging sensitivity, defined as the smallest follicle visualized, was greater using ultrasound biomicroscopy (0.33 +/- 0.07 mm) than it was using conventional ultrasound (1.5 +/- 0.21 mm; P < 0.0001). The mean follicle wall thickness was greater using conventional ultrasound (0.675 +/- 0.039 mm) compared with ultrasound biomicroscopy (0.254 +/- 0.017 mm), which in turn, was greater than that measured by histology (0.160 +/- 0.009 mm) (P < 0.0001). The mean granulosa and theca layer thickness measurements, respectively, were greater using ultrasound biomicroscopy (0.067 +/- 0.004 mm; 0.186 +/- 0.014 mm) compared with histology (0.034 +/- 0.002 mm; 0.126 +/- 0.008 mm) (P < or = 0.001). Protrusions from the follicle wall into the antrum, believed to represent cumulus-oocyte complexes, were visualized in five of 22 follicles using ultrasound biomicroscopy.
Conclusions:
The ultrasound biomicroscope was an effective tool to image human ovaries in vitro. Ultrasound biomicroscopy provided greater sensitivity and resolution for imaging ovarian follicles compared with conventional 2D ultrasonographic techniques.
