Diagnostic value of shear wave velocity in polycystic ovarian syndrome

Aim: In polycystic ovarian syndrome, the ovaries become stiffer due to chronicanovulation. We aimed to compare tissue elasticity in terms of shear wave velocitiesmeasured using acoustic radiation force impulse imaging technique between the ovaries ofpolycystic ovarian syndrome women and non-polycystic ovarian syndrome women. Materialand methods: The study was designed as a retrospective data analysis of women whounderwent transvaginal ultrasound and acoustic radiation force impulse imaging in auniversity hospital between July 2014 and March 2015, for various reasons. There were 32polycystic ovarian syndrome patients and 32 patients without a diagnosis of polycysticovarian syndrome. Age, body mass index, fasting glucose levels, cycle day 3 folliclestimulating hormone, luteinizing hormone, thyroid stimulating hormone, prolactin,antimullerian hormone levels, and menstrual patterns with clinical hyperandrogenism wereevaluated. On the menstrual cycle days 2–4, by performing a transvaginal ultrasoundscan, the ovarian volumes and antral follicle counts in both ovaries were recorded foreach woman. The ultrasound system was converted into the elastography mode, and acousticradiation force impulse imaging was performed. Shear wave velocity (m/sec) was measuredat least 5 times for each ovary, and the mean value was calculated for each polycysticovarian syndrome and non-polycystic ovarian syndrome woman. Results: Age, body massindex, fasting glucose levels, cycle day 3 follicle stimulating hormone, luteinizinghormone, thyroid stimulating hormone, and prolactin levels were similar between thegroups (p >0,05). Antimullerian hormone levels, antral follicle counts, and meanovarian volumes were statistically different between the groups (p <0,05). Mean shearwave velocity values for both ovaries were 2.12 ± 0.82 (0.78–4.9) m/sec in thepolycystic ovarian syndrome group, and 1.18 ± 0.41 (0.77–2.0) m/sec in thenon-polycystic ovarian syndrome group, which was statistically significantly different(p = 0.016). Conclusion: In our study, we found significantly higher shear wave velocitylevels in polycystic ovarian syndrome women than non-polycystic ovarian syndrome women,which indicates an impact of the condition on shear wave velocity. The increasedacoustic frequencies cause a decreased response in time to transition, and motionbecomes out of phase; in other words, scattered waves are faster in stiffer ovaries. Ourresults are thus compatible with the pathophysiology of the disease. Shear wave velocityis a beneficial tool for evaluating ovarian elasticity in polycystic ovarian syndromepatients in whom the levels are found to be significantly higher than non-polycysticovarian syndrome women. In light of these findings, shear wave velocity is expected tobe slower than polycystic ovarian syndrome levels in ovulatory women.