Usefulness of pelvic ultrasonography for the diagnosis of central precocious puberty in girls

Yu, Jung Sheng; Shin, Ha Young; Lee, Sun Hee; Kim, You Sung; Kim, Jae Hyun

doi:10.3345/kjp.2015.58.8.294

Cited by 21 publications

(20 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies have reported on the usefulness of ultrasound for CPP diagnosis [14-16]. Yu et al [14] reported that uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger on ultrasound in CPP patients (uterine length: 2.45±0.50 cm vs. 2.63±0.49 cm, P =0.015; uterine volume: 0.95±0.62 cm 3 vs. 1.35±0.76 cm 3 , P <0.001). However, these parameters are not useful for diagnostic purposes because they overlap.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Basal serum luteinizing hormone value as the screening biomarker in female central precocious puberty

Heo

Lee

2019

Ann Pediatr Endocrinol Metab

View full text Add to dashboard Cite

PurposePrecocious puberty refers to the development of secondary sex characteristics before ages 8 and 9 years in girls and boys, respectively. Central precocious puberty (CPP) is caused by premature activation of the hypothalamus-pituitary-gonadal (HPG) axis and causes thelarche in girls before the age of 8. A gonadotropin-releasing hormone (GnRH) stimulation test is the standard diagnostic modality for diagnosing CPP. However, the test cannot always be used for screening because it is expensive and time-consuming. This study aimed to find alternative reliable screening parameters to identify HPG axis activation in girls <8 years old (CPP) and for girls 8–9 years old (early puberty, EP).MethodsFrom January 2013 to June 2015, medical records from 196 girls younger than 9 years old with onset of breast development were reviewed, including 126 girls who had a bone age (BA) 1 year above their chronological age. All patients underwent a GnRH stimulation test, and 117 underwent pelvic sonography. The girls were divided into 4 groups based on age and whether the GnRH stimulation test showed evidence of central puberty. Subanalyses were also conducted within each group based on peak luteinizing hormone (LH) level quartiles.ResultsBasal serum LH level was the most sensitive marker for screening CPP and EP. The cutoff values were 0.245 IU/L for CPP under 8 years old (P=0.049, area under the curve [AUC]=0.764, 88% sensitivity, 48% specificity) and 0.275 IU/L for EP between 8–9 years old (P=0.005, AUC=0.813, 79% sensitivity, 77% specificity). Peak LH level decreased as BMI z-score among subgroups increased when there was no difference in BA; however, higher BA eliminated this effect.ConclusionsBasal serum LH level is a useful screening parameter for diagnosing CPP and EP in girls. Peak LH levels were lower with increasing BMI z-score, although older BA eliminated this effect.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Uterine length was measured from the fundus to the external opening at the maximum length of the midsagittal section in an anteroposterior direction. Ovary volume was estimated using the ellipse formula (length×height×transverse diameter×0.5233) [14], and the side of the ovary was noted.…”

Section: Methodsmentioning

confidence: 99%

Basal serum luteinizing hormone value as the screening biomarker in female central precocious puberty

Heo

Lee

2019

Ann Pediatr Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…for example, some have reported a significantly higher FCR in PP (22,24,27), whereas others have not (12,28). After pooling these studies, we found a meaningful difference in FCR between the PP and PT groups, suggesting that this parameter could successfully differentiate PP from PT.…”

Section: Summary Of Main Findingsmentioning

confidence: 58%

“…Previously, it has been, however, primarily indicated to exclude organic causes of peripheral early puberty, such as ovarian cysts and tumors (11)(12)(13). Moreover, international consensus on the definite cutoffs for ultrasonography measurements in PP is unavailable.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Female Pelvic Ultrasonography in Differentiating Precocious Puberty From Premature Thelarche: A Systematic Review and Meta-analysis

Nguyen

Huynh

et al. 2021

Front. Endocrinol.

View full text Add to dashboard Cite

BackgroundThe gonadotropin-releasing hormone (GnRH) stimulation test is the benchmark for diagnosing precocious puberty (PP). However, it is invasive, time-consuming, costly, and may create an unpleasant experience for participants. Moreover, some overlaps may occur between PP and premature thelarche (PT) in the early stage of PP. Female pelvic ultrasonography may provide additional information to help differentiate PP from PT and subsequently initiate early treatment. In this study, we aimed to first directly compare pelvic ultrasonography parameters between PP and PT groups and secondly, investigate their diagnostic accuracy compared with the GnRH stimulation test.MethodsA systematic search of the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane Library databases was performed up to March 31, 2021. All types of studies, except for case reports and review articles, were included. The GnRH stimulation test was used to confirm PP diagnosis. Those whose organic conditions might cause PP were excluded. The mean, standard deviation, sensitivity, and specificity of each parameter were documented. Forest plots were constructed to display the estimated standardized mean differences (SMDs) from each included study and the overall calculations. A bivariate model was used to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR).ResultsA total of 13 studies were included for analysis. The SMDs (95% confidence interval – CI) in ovarian volume, fundal-cervical ratio, uterine length, uterine cross-sectional area, and uterine volume between PP and PT groups were 1.12 (0.78–1.45; p < 0.01), 0.90 (0.07–1.73; p = 0.03), 1.38 (0.99–1.78; p < 0.01), 1.06 (0.61–1.50; p < 0.01), and 1.21 (0.84–1.58; p <0.01), respectively. A uterine length of 3.20 cm yielded a pooled sensitivity of 81.8% (95% CI 78.3%–84.9%), specificity of 82.0% (95% CI 61.0%–93.0%), PLR of 4.56 (95% CI 2.15–9.69), NLR of 0.26 (95% CI 0.17–0.39), and DOR of 19.62 (95% CI 6.45–59.68). The area under the summary receiver operating characteristics curve was 0.82.ConclusionFemale pelvic ultrasonography may serve as a complementary tool to the GnRH stimulation test in differentiating PP from PT.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232427, ID: CRD42021232427.

show abstract

“…Một số nghiên cứu đưa ra các tiêu chuẩn chẩn đoán cho nồng độ FSH nền trong huyết thanh nhưng có độ nhạy và độ đặc hiệu thấp [3], [11]. Ngược lại, nồng độ hormone sinh dục nữ (Estradiol) huyết thanh lại không có sự khác biệt giữa 2 nhóm nghiên cứu (bảng 3.7), tương tự với các nghiên cứu trước đây, của Liat de Vries (2004), Jung Yu (2015) [8], [10]. Tương đồng với một số nghiên cứu trước đây, bảng 3.9 cho thấy các chỉ số siêu âm tử cung buồng trứng có giá trị trong chẩn đoán phân biệt dậy thì sớm trung ương và tuyến vú phát triển sớm bao gồm chiều cao tử cung, chiều rộng tử cung, chiều trước sau tử cung, thể tích tử cung và thể tích buồng trứng với p < 0,05 [9],[10],[12],[13].…”

Section: đặC đIểm Lâm Sàng Và Cận Lâm Sàng Của Dậy Thì Sớm ở Trẻ Gáiunclassified

Đặc điểm lâm sàng, cận lâm sàng và các chỉ số siêu âm tử cung buồng trứng trong dậy thì sớm ở trẻ gái

Nguyễn¹,

Hoàng²,

Nguyễn³

2021

vjde

View full text Add to dashboard Cite

Mục tiêu: Nghiên cứu mô tả đặc điểm lâm sàng, cận lâm sàng của dậy thì sớm trung ương (DTSTƯ) và tuyến vú phát triển sớm (TVPTS) và xác định giá trị của các chỉ số siêu âm tử cung buồng trứng trong chẩn đoán phân biệt dậy thì sớm trung ương vô căn và tuyến vú phát triển sớm ở trẻ gái. Phương pháp nghiên cứu: Mô tả cắt ngang. Nghiên cứu gồm 58 các trẻ gái có tuyến vú phát triển trước 8 tuổi từ tháng 5 năm 2017 đến tháng 7 năm 2019. Kết quả: Có 34 (58,62%) trẻ DTSTƯ và 24 (41,38%) trẻ TVPTS. Nồng độ hormone LH, FSH và tỷ số LH/FSH trong huyết thanh và tỷ lệ tuổi xương lớn hơn tuổi thực có ý nghĩa của nhóm DTSTƯ cao hơn nhóm TVPTS p<0,05. Chiều cao, chiều rộng, chiều trước sau, thể tích tử cung và thể tích buồng trứng của nhóm DTSTƯ lớn hơn nhóm TSPTS p<0,05. Chiều cao tử cung >29,00mm có giá trị nhất trong chẩn đoán DTSTƯ với AUC là 0,770 (khoảng tin cậy 95% là 0,641-0,870). Kết luận: Khó phân biệt DTSTƯ và TVPTS bằng các dấu hiệu lâm sàng. Các chỉ số của tử cung và buồng trứng trên siêu âm của nhóm DTSTƯ lớn hơn nhóm TVPTS có ý nghĩa về mặt thống kê. Vì vậy, nên kết hợp các chỉ số siêu âm tử cung buồng trứng với các dấu hiệu lâm sàng và xét nghiệm sinh hóa trong chẩn đoán DTSTƯ ở trẻ gái.

show abstract

Usefulness of pelvic ultrasonography for the diagnosis of central precocious puberty in girls

Cited by 21 publications

References 27 publications

Basal serum luteinizing hormone value as the screening biomarker in female central precocious puberty

Basal serum luteinizing hormone value as the screening biomarker in female central precocious puberty

Diagnostic Accuracy of Female Pelvic Ultrasonography in Differentiating Precocious Puberty From Premature Thelarche: A Systematic Review and Meta-analysis

Đặc điểm lâm sàng, cận lâm sàng và các chỉ số siêu âm tử cung buồng trứng trong dậy thì sớm ở trẻ gái

Contact Info

Product

Resources

About