ELASTOGRAPHY IN OVARIAN IMAGING: EMERGING APPLICATIONS IN PCOS AND PCOM

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders affecting women of reproductive age and is frequently associated with infertility, menstrual irregularities, hyperandrogenism, obesity, and insulin resistance. Polycystic ovarian morphology (PCOM), characterized by increased follicle number and enlarged ovarian volume, represents the characteristic imaging appearance of the disorder. Conventional ultrasonography remains the primary imaging modality for ovarian evaluation; however, it provides limited information regarding stromal tissue composition, fibrosis, and biomechanical properties. In recent years, elastography has emerged as an advanced ultrasound-based technique capable of assessing tissue stiffness and elasticity in real time,thereby offering additional functional information beyond routine morphological assessment.Both strain elastography and shear wave elastography (SWE) have demonstrated promising applications in ovarian imaging. Studies have shown that ovaries affected by PCOS and PCOM exhibit increased stromal stiffness due to stromal hypertrophy, collagen deposition, fibrosis, hyperthecosis, and chronic lowgrade inflammation.