Intravoxel incoherent motion magnetic resonance imaging and derived parameters in the assessment for polycystic ovary syndrome

Abstract

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinologic disorder in reproductive age. Diagnosis is based on clinical, laboratory, and ultrasonography findings. However, the application of ultrasound for the diagnosis of PCOS in overweight and sexually inactive patients may be limited. The purpose of this study was to display the imaging characteristics of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI)-derived parameters as Dtrue (slow diffusion coefficient), D* (perfusion-related diffusion), f (perfusion fraction), and apparent diffusion coefficient (ADC) in PCOS. Results: A total of 43 women, 20 with PCOS (mean age, 24.09 +/- 3.92 years) and 23 healthy control (mean age, 23 +/- 1.67 years), were included. IVIM MRI-derived parameters of the ovarian stroma were measured by two observers. Mean D* and fvalues were found to be higher in PCOS patients than in individuals in the control group (p = 0.011 and p= 0.004, respectively). The ADC value was found to be significantly lower in the patient group (p = 0.003). There was no statistically significant difference between two groups in Dtrue (p = 0.742). The interclass correlation analysis of two observers for both groups showed a good-to-excellent agreement. The ROC produced an AUC of 0.521, a sensitivity of 50%, a specificity of 57%, and a cut-off value of 1.48 x 10(-3) mm(2)/s for Dtrue; an AUC of 0.769, a sensitivity of 55%, a specificity of 67%, and a cut-off value of 22.25 x 10(-3) mm(2)/s for D*; an AUC of 0.734, a sensitivity of 55%, a specificity of 62%, and a cut-off value of 20.87% for f, an AUC of 0.893, a sensitivity of 90%, a specificity of 33%, and a cut-off value of 1.37 x 10(-3) mm(2)/s for ADC. Conclusions: IVIM MRI would be an alternative imaging tool in the diagnosis of PCOS with a good-to-excellent agreement and with acceptable sensitivity and specificity.