Abstract:
Objective To explore the value of pelvic ultrasound in evaluating precocious puberty in girls and different types of precocious puberty.
Methods Thirty girls with central precocious puberty (CPP) and 30 girls with peripheral precocious puberty (PPP) diagnosed clinically from August 2019 to August 2021 were selected, and 30 girls with no significant abnormalities in pelvic ultrasound, gonadotropin releasing hormone (GnRH) stimulation test, and bone age measurement were selected as a normal control group. All the children underwent pelvic ultrasound examination. The differences in age, body mass index, uterine thickness, uterine length diameter/cervical length diameter, uterine volume, ovarian volume, and maximum follicular length diameter were compared among the three groups of girls, and the ROC curves of different ultrasound parameters for CPP, PPP, and normal subjects were drawn to evaluate the evaluation efficiency of each parameter.
Results The uterine thickness, uterine volume, ovarian volume, and maximum follicular length diameter in the CPP group were significantly higher than those in the control group and PPP group (P<0.05). The uterine thickness, uterine volume, ovarian volume, and maximum follicular length diameter in the PPP group were significantly higher than those in the control group (P<0.05). Taking the GnRH stimulation test as the gold standard, the areas under the ROC curves of uterine thickness, uterine volume, ovarian volume, and maximum follicle length diameter to distinguish CPP and PPP were 0.900, 0.849, 0.843, and 0.755; the areas under the ROC curves to distinguish CPP from normal girls were 0.941, 0.887, 0.926, and 0.769; and the areas under the ROC curves to distinguish PPP from normal girls were 0.814, 0.811, 0.706, and 0.813, respectively. The area under the ROC curve of uterine thickness was the largest, and the cut-off value of uterine thickness>1.39 cm yielded an 86.7% sensitivity and 90.0% specificity in identifying girls with CPP and PPP. Taking the uterine thickness>1.07 cm as the cut-off value, the sensitivity and specificity for distinguishing CPP from normal girls were 96.7% and 90.0%, respectively. Taking the uterine thickness>0.96 cm as the cut-off value, the sensitivity and specificity for distinguishing PPP from normal girls were 80.0% and 86.7%.
Conclusion Multiple parameters of pelvic ultrasound have good clinical application value in the evaluation of girls' precocious puberty and the identification of different types. As a new evaluation parameter, uterine body thickness deserves further attention. These parameters can be used as the primary screening method for precocious puberty to provide a reliable basis for clinical diagnosis.
Key words:
Precocious puberty,
Ultrasonography,
Uterus,
Ovary
Bin Xia, Huaxing Wei, Chenke Pan, Yunkai Luo, Huiling He, Shouxing Xu, Zhelan Zheng. Value of pelvic ultrasound in evaluating precocious puberty in girls[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(04): 360-365.