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- Dahlgren, Eva, et al.
(författare)
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Sertoli-Leydig cell tumour in a postmenopausal woman showing all facets of the insulin resistance syndrome (IRS)
- 2005
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Ingår i: Ups J Med Sci. - 0300-9734. ; 110:3, s. 233-6
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Tidskriftsartikel (refereegranskat)abstract
- Sertoli-Leydig cell tumours are rare sex stromal tumours with an incidence of < 0.5% of all ovarian tumours. Most frequently this tumour occurs in young women with a history of amenorrhoea, hirsutism and lowered pitch. Here, we report on a woman with IRS, postmenopausal virilization and increased testosterone levels due to a Sertoli-Leydig cell tumour. This is the first case to suggest an association between IRS and Sertoli-Leydig cell tumours. Furthermore, we highlight the difficulties in detecting this ovarian tumour with sonography.
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| 3. |
- Gull, Berit, 1953
(författare)
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Transvaginal sonography of the endometrium in postmenopausal women
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Postmenopausal bleeding (PMB)may be a sign of endometrial cancer (EC)but EC canalso be found in postmenopausal women without bleeding.The traditionally acceptedmethod of evaluating the endometrium is dilatation and curettage (D&C)or endometrialbiopsy.Recently non-invasive evaluation of the endometrium by transvaginal sonography(TVS)has been increasingly utilised,sometimes complimented with the use of salineinstillation sonography (SIS).Aims:The aims were:(i)to study the normal variation of endometrial thickness (ET)in arandom sample of postmenopausal women;(ii)to evaluate factors associated with ET anduterine size;(iii)to determine the prevalence of uterine cavity fluid and if the presence offluid is associated with an increased risk of EC;(iv)to assess the possibility of refrainingfrom endometrial biopsy in women with PMB when ET is thin (=4 mm);and (v)toevaluate PMB and ET as predictors of EC in women followed =10 years after a PMB.Material and methods:1000 women aged 45-80 years,randomly chosen from theNational Population Register were invited to answer a questionnaire and undergo agynecological and a TVS examination (Paper I-III).A group of 361 women consecutivelyreferred for investigation of PMB were followed with TVS,a cervical smear and possiblebiopsy for one year (Paper IV).Women (n =394)who presented with PMB during 1987-1990 were followed =10 years after the primary investigation which included TVS (PaperV).Results:A TVS examination was performed in 827 of the 1000 women invited toparticipate and of these 559 were postmenopausal.The majority of the asymptomaticpostmenopausal women had a thin ET (90%)as measured by TVS (Paper I).The onlyfactors associated with ET were use of hormone replacement therapy (HRT)and co-existingfibroids while HRT,fibroids,age,parity,smoking,hypertension and the presence ofdiabetes mellitus were associated with uterine size parameters (Paper II).Uterine cavityfluid was diagnosed in 9%of the asymptomatic women but was not associated with anincreased risk of malignancy when associated with a thin endometrium (Paper III).Theincidence of EC was 0,6%in the 163 women with PMB who had an ET =4 mm at theinitial TVS examination (Paper IV).PMB incurred a 64-fold increase in the risk of EC andno EC was missed when ET was =4 mm even if the women were followed =10 years(Paper V).Conclusions:The study performed in a random sample of the total population did notgive any data to support the use of TVS as a screening method in asymptomatic womenfrom the general population.Neither did the evaluated factors investigated give any supportto screening specific riskgroups.A thin ET (=4 mm)in women with PMB can be safelyfollowed with TVS without endometrial biopsy and uterine cavity fluid does not seem tobe a risk factor for EC in asymptomatic women.A thick endometrium and recurrentbleeding are highly predictive for later development of EC.
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| 6. |
- Leonhardt, Henrik, 1963, et al.
(författare)
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Ovarian morphology assessed by magnetic resonance imaging in women with and without polycystic ovary syndrome and associations with antimullerian hormone, free testosterone, and glucose disposal rate.
- 2014
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282 .- 1556-5653. ; 101:6
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Tidskriftsartikel (refereegranskat)abstract
- Abstract OBJECTIVE: To characterize ovarian morphology and perfusion by magnetic resonance imaging (MRI) in women with and without polycystic ovary syndrome (PCOS) and to investigate associations with antimüllerian hormone (AMH), free T, and glucose disposal rate (GDR). DESIGN: Explorative cross-sectional study. SETTING: University hospital. PATIENT(S): Fifty-eight women with PCOS and 31 controls from the general population. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Antral follicle count (AFC), ovarian/stromal volume, perfusion, AMH, free T, and GDR. RESULT(S): Antral follicles of 1-3 and 4-6 mm, but not 7-9 mm, were more numerous, and total AFC (1-9 mm) was higher in women with PCOS. Ovarian volume was larger in women with PCOS. AMH and free T were higher and GDR was lower in women with PCOS. All values were more deranged in classic compared with nonclassic PCOS. There was a positive correlation between AMH and AFC, 1-3 mm (r = 0.81), and between AMH and total AFC (r = 0.87). In receiver operating characteristic analyses, the area under the curve was 0.89 for total AFC, 0.86 for AMH, and 0.90 for free T. PCOS was independently associated with AFC and free T but not with AMH or GDR when adjusted for age and body mass index. CONCLUSION(S): Counting antral follicles down to 1 mm in size by MRI yielded higher AFCs than previously reported. AFC, AMH, and free T discriminated with high accuracy between women with PCOS and controls, but AMH was not independently associated with PCOS.
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| 7. |
- Leonhardt, Henrik, 1963, et al.
(författare)
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Ovarian volume and antral follicle count assessed by MRI and transvaginal ultrasonography: a methodological study.
- 2014
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Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 55:2, s. 248-256
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Ultrasonographic measurements of ovarian volume and antral follicle count are of clinical importance as diagnostic features of polycystic ovarian syndrome (PCOS), and as a parameter in estimation of ovarian follicular reserve in infertility care. PURPOSE: To compare two-dimensional (2D)/three-dimensional (3D) transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI) for estimation of ovarian volume and antral follicle count, and to assess reproducibility and inter-observer agreement of MRI measurements. MATERIAL AND METHODS: Volumes of 172 ovaries in 99 women aged 21-37 years were calculated (length x width x height x 0.523) with conventional 2D TVUS and 2D MRI. Semi-automatic estimates of ovarian volumes were obtained by 3D MRI. Antral follicles were counted manually on 2D MRI and automatically by 3D TVUS (SonoAVC), and stratified according to follicle size. RESULTS: Mean ovarian volume assessed by 2D TVUS (13.1±6.4mL) was larger than assessed by 2D MRI (9.6±4.1) and 3D MRI (11.4±4.5) (P<0.001). Total follicle count was higher by 2D MRI than by 3D TVUS, mean difference 14.3±16.2 follicles (P<0.001). In the smallest size interval of 1-3mm the mean difference was 22.2±17.6 (P<0.001). Intra- and inter-observer absolute agreement assessment for MRI measurements of ovarian volume and total follicle count showed ICC coefficients >0.77. CONCLUSION: 2D MRI reveals more antral follicles, especially of small size, than 3D TVUS. Ovarian volume estimation by MRI provides smaller volumes than by the reference standard 2D TVUS. Ovarian volume estimation by 3D MRI, allowing independence of non-ellipsoid ovarian shape measurement errors, provides volumes closer to 2D TVUS values than does 2D MRI. Reproducibility and inter-observer agreement of 2D MRI measurements of ovarian volume and total follicle count are good.
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| 9. |
- Leonhardt, Henrik, 1963, et al.
(författare)
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Uterine morphology and peristalsis in women with polycystic ovary syndrome.
- 2012
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 53:10, s. 1195-1201
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPolycystic ovary syndrome (PCOS) is associated with chronic oligo-anovulation and high circulating sex hormone levels. Women with PCOS have an increased risk of developing endometrial cancer. In anovulatory women with PCOS a positive relationship between endometrial thickness and endometrial hyperplasia has been observed. Uterine peristalsis, which has been suggested to be of importance for female fertility, has not previously been studied in PCOS.PurposeTo assess whether women with PCOS have altered endometrial thickness, uterine wall morphology, and peristalsis.Material and MethodsIn this prospective case-control study 55 women with PCOS (mean age, 29.5 years ± 4.5 SD) and 28 controls (27.6 ± 3.2) were examined using magnetic resonance imaging (MRI), assessing thickness of endometrium, junctional zone (JZ), and myometrium, and evaluating the occurrence, frequency (waves/min), strength (amplitude), pattern, and direction of peristalsis. Uterine morphology was also assessed by transvaginal ultrasonography (TVUS).ResultsThe endometrium was thinner in PCOS with oligo-amenorrhea compared to controls, also after adjustments for age and BMI (adjusted P = 0.043). There was no difference in thickness of the JZ or the myometrium in cases versus controls. Uterine peristalsis was less commonly observed in women with PCOS than in controls (adjusted P = 0.014).ConclusionThere were no differences in myometrial morphology between PCOS and controls, but the endometrium was thinner in PCOS with oligo-amenorrhea. Based on cine MRI, uterine peristalsis was less common in PCOS than in controls.
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