Interrelationship between ultrasonography and biology in the diagnosis of polycystic ovarian disease by cluster analysis [A new concept]

ABSTRACT

In order to compare the diagnostic signification of hormonal and ultrasonic criteria of polycystic ovarian disease [PCOD], the presence or the absence of ultrasonographic and homonal features of PCOD were recorded in an, heterogeneous population of 90 women presenting with hyperandrogenism and/or menstrual disorders. On clinical and hormonal grounds exclusively, these patients could be separated in five diagnostic subgroups presumed cases of PLOD- [n = 21], idiopathic hisutism [IH] [n = 26], hypothalamic anovulation [HA] [n = 11], hyperprcrlactinaemia [HPRL] [n = 9], and miscellaneous or undetermined diagnosis [u = 23]. By the means of computed automatic classification of patients [cluster analysis] using hormonal and ultrasonic criteria of PCOD, four homogeneous clusters of patients were obtained. Cluster number sign 1 [25 patients] had the most characteristic profile of PCOD. It included 15 cases of POD and 7 cases of III. Cluster [47patients] had the less characteristic profile of PCOD. It included the majority of patients with HA and HPRL and half of the patiests with IH. Cluster number sign 2 included only 2 hyperandrogenic patients who were massively obese and in whom ultrasonography [US] may have failed to detect PCOD. Cluster number sign 3 [1.6 patients] included patients from each diagnostic group, who are gathered. together because US and hormonal features were Present and absent in nearly all of them, respectively. With the same analysis, the criteria of PCOD could be graded according to their grouping potency. The presence of an abnormal ovarian stroma by US appeared as the most potent criterion. Elevated serum Testosterone and Androstenedione levels and the polyfollicular pattern of ovariess gave intermediate results while the elevated basal LH level was a ranch weaker grouping parameter. In conclusion, the automatic classification of patients by cluster analysis using both hormonal and US eriteria revealed that the classical diagnostic classification lying upon hormonal data exclusively may arbitrarily separate patients having the,carne disease andd that ultrasanography affords pertinent information that should help to a better diagnostic definition of [PCOD]