String of pearls sign (ovary)

Last revised by Dr Daniel J Bell on 27 Apr 2020

The string of pearls (or beads) sign in the ovary is the ultrasound sign of multiple small (<5 mm) follicles peripherally located in the gonad.

It is typically seen in polycystic ovaries, and is thought to represent abnormal accumulation of immature follicles. This morphologic appearance however does not contribute to the diagnostic criteria of polycystic ovarian syndrome.

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