Relationship between ultrasonography and histopathological changes in polycystic ovarian syndrome

We investigated retrospectively the relationship between the ultrasonographic appearance of the ovaries and histopathological findings in patients with polycystic ovarian syndrome (PCOS) and compared these histopathological findings with endocrine concentrations. A total of 20 patients with PCOS were studied. Each patient had a history of infertility, menstrual disturbance and > 10 small cysts in each ovary that were detected by transvaginal ultrasound. Ovarian ultrasound appearance was classified as a general cystic pattern (GCP) or peripheral cystic pattern (PCP). Histological examination of specimens from patients undergoing ovarian wedge resection by laparotomy were compared with ultrasonographic images. In 15 of the 16 ovaries with GCP, the histopathological findings were consistent with the ultrasonographic images. In all 24 ovaries with PCP, the histopathological and ultrasonographic images were consistent. The mean ovarian capsular thickness was significantly higher in the GCP than the PCP. Androstenedione was significantly higher in the GCP than the PCP, whereas the ratio of luteinizing hormone to follicle-stimulating hormone was significantly higher in the PCP than the GCP. Therefore, our results suggested that GCP and PCP correspond to histopathological differences. Histological GCP and PCP appear to differ endocrinologically.