The Effectiveness of Pelvic Ultrasonography Findings in Diagnosing Precocious Puberty.

IF 0.7 4区医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Ultrasound Quarterly Pub Date : 2025-02-25 eCollection Date: 2025-03-01 DOI:10.1097/RUQ.0000000000000705

Fatma Özgüç Çömlek, Mehmet Öztürk, Ahmet Fatih Yılmaz, Muslu Kazım Körez, Fuat Buğrul, Muammer Büyükinan

{"title":"The Effectiveness of Pelvic Ultrasonography Findings in Diagnosing Precocious Puberty.","authors":"Fatma Özgüç Çömlek, Mehmet Öztürk, Ahmet Fatih Yılmaz, Muslu Kazım Körez, Fuat Buğrul, Muammer Büyükinan","doi":"10.1097/RUQ.0000000000000705","DOIUrl":null,"url":null,"abstract":"Objective: Gonadotropin-releasing hormone (GnRH) stimulation testing is the gold standard for distinguishing central precocious puberty (CPP) from premature thelarche (PT). Due to the limitations of this test, previous studies have elucidated the clinical and laboratory factors that predict CPP. This study explored the diagnostic importance of pelvic ultrasound in girls with CPP.Method: Between May 2023 and May 2024, 55 girls with suspected CPP underwent a GnRH stimulation test and pelvic ultrasonography (PU). Additionally, bone ages were evaluated using a left wrist x-ray.Result: The multivariate analysis found that basal luteinizing hormone (bLH) > 0.67 IU/L, basal follicle-stimulating hormone (FSH) > 3.5 IU/L, basal estradiol > 7.5 pg/mL, uterine volume > 2.6 cm3, and longitudinal uterine diameter >35 mm were significantly associated with a pubertal response at the GnRH test. The 2 groups had no difference in bone age and bLH/basal FSH values. Peak LH/FSH ratio had the best diagnostic performance, with an area under the curve of 0.956 (95% confidence interval, 0.864-0.993), a sensitivity of 81.82%, a specificity of 96.97%, a positive predictive value of 94.7%, and a negative predictive value of 88.9%. The optimal cutoff value was >0.59 for the LH/FSH ratio.Conclusions: Uterine long axis and uterine volume measurements are noninvasive data that help distinguish CPP from PT.","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":"41 1","pages":""},"PeriodicalIF":0.7000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ultrasound Quarterly","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/RUQ.0000000000000705","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Gonadotropin-releasing hormone (GnRH) stimulation testing is the gold standard for distinguishing central precocious puberty (CPP) from premature thelarche (PT). Due to the limitations of this test, previous studies have elucidated the clinical and laboratory factors that predict CPP. This study explored the diagnostic importance of pelvic ultrasound in girls with CPP.

Method: Between May 2023 and May 2024, 55 girls with suspected CPP underwent a GnRH stimulation test and pelvic ultrasonography (PU). Additionally, bone ages were evaluated using a left wrist x-ray.

Result: The multivariate analysis found that basal luteinizing hormone (bLH) > 0.67 IU/L, basal follicle-stimulating hormone (FSH) > 3.5 IU/L, basal estradiol > 7.5 pg/mL, uterine volume > 2.6 cm3, and longitudinal uterine diameter >35 mm were significantly associated with a pubertal response at the GnRH test. The 2 groups had no difference in bone age and bLH/basal FSH values. Peak LH/FSH ratio had the best diagnostic performance, with an area under the curve of 0.956 (95% confidence interval, 0.864-0.993), a sensitivity of 81.82%, a specificity of 96.97%, a positive predictive value of 94.7%, and a negative predictive value of 88.9%. The optimal cutoff value was >0.59 for the LH/FSH ratio.

Conclusions: Uterine long axis and uterine volume measurements are noninvasive data that help distinguish CPP from PT.

查看原文本刊更多论文

盆腔超声检查诊断性早熟的有效性。

目的：促性腺激素释放激素（GnRH）刺激试验是鉴别中枢性性早熟（CPP）和性早熟（PT）的金标准。由于该试验的局限性，以往的研究已经阐明了预测CPP的临床和实验室因素。本研究探讨盆腔超声在女孩CPP诊断中的重要性。方法：于2023年5月至2024年5月对55例疑似CPP的女孩行GnRH刺激试验及盆腔超声检查（PU）。此外，使用左手腕x光片评估骨年龄。结果：多因素分析发现，促黄体生成素(bLH) > 0.67 IU/L、促卵泡激素(FSH) > 3.5 IU/L、雌二醇> 7.5 pg/mL、子宫体积> 2.6 cm3、子宫纵向直径>35 mm与GnRH试验中青春期反应显著相关。两组骨龄、bLH/基础FSH值无差异。峰值LH/FSH比值的诊断效果最好，曲线下面积为0.956(95%可信区间0.864 ~ 0.993)，敏感性为81.82%，特异性为96.97%，阳性预测值为94.7%，阴性预测值为88.9%。LH/FSH比值的最佳临界值为0.59。结论：子宫长轴和子宫体积测量是非侵入性数据，有助于区分CPP和PT。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Ultrasound Quarterly RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.50

自引率

7.70%

发文量

105

审稿时长

>12 weeks

期刊介绍： Ultrasound Quarterly provides coverage of the newest, most sophisticated ultrasound techniques as well as in-depth analysis of important developments in this dynamic field. The journal publishes reviews of a wide variety of topics including trans-vaginal ultrasonography, detection of fetal anomalies, color Doppler flow imaging, pediatric ultrasonography, and breast sonography. Official Journal of the Society of Radiologists in Ultrasound