PCOS has historically been diagnosed clinically, often supported by
laboratory parameters. However, the role of ultrasound has evolved over time. While
initially used to identify features consistent with PCOS, its interpretation has become
more complex. The presence of a “string of pearls” appearance on ultrasound has
contributed to the perception of PCOS, but this may not always accurately reflect the
condition. Advancements in ultrasound technology, particularly with higher frequency
probes and endovaginal imaging, have improved the visualization of ovarian structures.
However, there is inconsistency in how ultrasound findings are interpreted by
clinicians and understood by patients. The presence of multifollicular ovaries, often
observed on ultrasound, is frequently associated with PCOS, yet the significance of this
finding in relation to the different PCOS phenotypes remains uncertain.
Keywords: PCOS, Pulsatility index, Resistivity index, Vascularization index.
