Diagnostic value of shear wave velocity in polycystic ovarian syndrome
Authors:   Department of Obstetrics and
            Gynecology, University of Health Sciences Turkey Zeynep Kamil Maternity and Children’s
            Training And Research Hospital, Istanbul, Turkey, Turkey, Gursu Turkan , Cevik Halime ,   Department of Radiology,
            Okan University Hospital, Istanbul, Turkey, Turkey, Desteli Güldeniz Aksan ,   Department of Obstetrics and
            Gynecology, Baskent University Istanbul Hospital, Istanbul, Turkey,
            Turkey, Yilmaz Birnur ,   Department of Radiology,
            Okan University Hospital, Istanbul, Turkey, Turkey, Bildaci Tevfik Berk ,   Department of Obstetrics and
            Gynecology, Baskent University Istanbul Hospital, Istanbul, Turkey,
            Turkey, Eraslan Alper ,   Department of Obstetrics and
            Gynecology, Reproductive Endocrinology Division, Dünya IVF Center, Kyrenia, Cyprus,
            Turkey
Published: December 2021

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