Ultrasonic and endocrinologic aspects in gonadotropin releasing hormone induction of ovulation.

Ovarian growth, follicular size, 17 beta-estradiol (E2), androstenedione (A) and testosterone (T) peripheral levels were evaluated in 12 hypogonadotropic patients during the follicular phase on 12 cycles of pulsatile GnRH iv administration. During GnRH therapy, significant correlations between E2 plasma levels and volume of the dominant follicle (p less than 0.001) as well as total follicular volume (p less than 0.001) and total ovarian volume (p less than 0.01) were found. Plasma A was significantly related to the ultrasonic changes of ovarian stroma and those follicles which usually fail to ovulate. Plasma T showed a significant correlation with ovarian stroma (p less than 0.05). Significant correlations of E2/A and E2/T peripheral ratios with volume of the dominant follicle (p less than 0.01) were also found. In spontaneous ovulatory cycles, similar correlations between endocrine and morphological parameters have been already published. The findings of the present investigation indicate that in spontaneous and GnRH-induced cycles the endocrine events associated to the follicular development are quite similar. In hypogonadotropic patients, a "normal" follicular maturation may be obtained by means of this therapy.

[Ultra-low field magnetic resonance in the diagnosis of ovarian lesions]. / La risonanza magnetica a campo ultra basso nella diagnostica delle lesioni ovariche.

To investigate the diagnostic capabilities of ultra low field MRI in the characterization of adnexal conditions, 46 women (aged 17 to 83 years) with US diagnosis of tubo-ovarian diseases were examined with MRI. An 0.064 T permanent magnet was used (toshiba Access), with T1- and T2-weighted spin-echo (SE) sequences, 3D T1-weighted gradient-echo (GE) sequences and, in 5 patients, a STIR sequence. Compared with surgical (37 patients), needle biopsy (3 patients) and clinical follow-up (6 patients) findings, MR diagnostic accuracy was 86.9%, which is comparable with literature data at higher field strength. The most common diagnostic error in our series was in the differential diagnosis between dermoid cyst and endometriosis which exhibited similar MR patterns. This limitation seems to be overcome by using STIR sequences with 60 ms T1 which, at this field strength, can suppress fat signal completely, whereas blood signal intensity remains high. The MR signal patterns of each group of conditions are also reported: in some cases, such patterns differ from those reported at higher field strength due to different T1 and T2 tissue relaxation times.

Steroid hormones and gonadotropins in a case of ovarian endometriosis associated with virilization.

The clinical course, the hormone secretion, the testosterone receptors and the enzymatic activities related to androgen metabolism in a 56-year-old postmenopausal woman with a history of virilization and ovarian endometrioma are reported. Unexpectedly, at the time of examination, no evidence of biochemical hyperandrogenism was obtained. The uncommon association of virilization and ovarian endometrioma simulating a functioning tumor of the ovary is discussed.