Clinical Usefulness of Pelvic Ultrasound in Diagnosis of Precocious Puberty

Duk Hyun Kim, S. Jung, Jeongho Lee
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Abstract

Objective: Precocious puberty is the adrenarche that occurs before the age of 8 in girls. Gonadotropin-releasing hormone stimulation test (GnRH stimulation test), which is widely used in diagnosing precocious puberty, is commonly used to evaluate the activity of the hypothalamus-pituitary-gonad axis, but it has the disadvantages of low sensitivity and laborious blood sampling process. On the other hand, pelvic ultrasonography has the advantage of being inexpensive and easy to test. The purpose of this study was to investigate the usefulness of pelvic ultrasonography for the diagnosis of precocious puberty and whether there is a significant relationship between the GnRH stimulation test and ultrasonography findings.Methods: From January 2016 to September 2021, a total of 234 girls with precocious puberty who visited the Soonchunhyang University Seoul Hospital were subjected to pelvic ultrasonography.Results: The size of both ovaries in the group with a peak luteinizing hormone (LH) value of 10 IU/L or higher in the GnRH stimulation test was significantly larger than that of the group with a peak LH value of less than 7 IU/L. A group with a peak LH value of 10 IU/L or higher in the GnRH stimulation test had 0.63 cm and 0.9 cm significantly larger uterus size than that of the other two groups.Conclusion: Uterus and ovary sizes have a positive correlation with peak LH values in the GnRH stimulation test. Pelvic ultrasonography is considered to be a useful test for estimating precocious puberty without causing much discomfort to the child.
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盆腔超声诊断性早熟的临床价值
目的:性早熟是指女孩在8岁前出现的肾上腺增生。促性腺激素释放激素刺激试验(Gonadotropin-releasing hormone stimulation test,简称GnRH刺激试验)广泛用于性早熟的诊断,常用于评估下丘脑-垂体-性腺轴的活性,但存在敏感性低、采血过程繁琐等缺点。另一方面,盆腔超声检查具有便宜和易于检测的优点。本研究的目的是探讨盆腔超声对性早熟的诊断价值,以及GnRH刺激试验与超声检查结果之间是否存在显著关系。方法:对2016年1月至2021年9月在顺天香大学首尔医院就诊的234例性早熟女童进行盆腔超声检查。结果:GnRH刺激试验中促黄体生成素(LH)峰值为10 IU/L及以上组双卵巢大小明显大于LH峰值小于7 IU/L组。GnRH刺激试验LH峰值≥10 IU/L组子宫尺寸分别比其他两组大0.63 cm和0.9 cm,差异有统计学意义。结论:GnRH刺激试验中,子宫和卵巢大小与LH峰值呈正相关。盆腔超声检查被认为是一个有用的测试,以估计性早熟,而不会引起太多的不适的孩子。
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