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[Polycystic ovaries: an imprecise ultrasonographic definition]
Y Ardaens1, Y Robert, D Dewailly
1Service de radiologie ouest CHU, Lille.
Abstract:
In the absence of a precise definition, the terms "ovarian dystrophy" are often erroneously used. Therefore we propose a more modern terminology which allows to distinguish two types of ovarian follicle pathology: the microfollicular disease results from a follicular arrest of maturation, leading to an accumulation of immature microfollicles in the ovarian cortex. The clinical correlate is anovulation. This disease encompasses two aetiologic entities: polycystic ovarian disease (PCO) and the multifollicular ovaries (MFO), which were previously gathered under the label of "endocrinal ovarian dystrophy"; the macrofollicular disease results from the excessive growth of one or several follicles with or without luteinisation. Its clinical correlate is pelvic pain. It includes three main aetiologies: macropolycystic ovaries, functional cysts and LUF syndrome. These could also be termed "mechanical or local dystrophy". This new classification allows to consider two distinct anatomical entities which represent the whole of functional ovarian pathology.
Insights
The study proposes a new terminology for ovarian follicle pathology, distinguishing microfollicular disease (anovulation) from macrofollicular disease (pelvic pain). This clarifies terminology for ovarian dysfunction and related conditions.
Area of Science:
- Reproductive Endocrinology
- Gynecology
- Pathology
Background:
- The term 'ovarian dystrophy' lacks a precise definition and is often misused.
- Existing classifications do not adequately distinguish between different types of ovarian follicle pathology.
Purpose of the Study:
- To propose a modern terminology for ovarian follicle pathology.
- To differentiate between microfollicular and macrofollicular ovarian diseases.
- To establish clear clinical correlates and etiological entities for each type.
Main Methods:
- Review and analysis of existing literature on ovarian pathology.
- Development of a new classification system based on follicle maturation and growth.
- Correlation of pathological findings with clinical symptoms and etiological factors.
Main Results:
- Two distinct types of ovarian follicle pathology are identified: microfollicular disease and macrofollicular disease.
- Microfollicular disease is characterized by arrested maturation, leading to anovulation, and includes polycystic ovarian disease (PCO) and multifollicular ovaries (MFO).
- Macrofollicular disease involves excessive follicle growth, causing pelvic pain, and includes macropolycystic ovaries, functional cysts, and LUF syndrome.
Conclusions:
- The proposed terminology provides a clearer distinction between ovarian follicle pathologies.
- This classification aids in understanding the clinical manifestations and etiological factors of ovarian dysfunction.
- The new terminology encompasses the spectrum of functional ovarian pathology, improving diagnostic accuracy.