Fugl Louise, Hagen Casper P, Mieritz Mikkel G, Tinggaard Jeanette, Fallentin Eva, Main Katharina M, Juul Anders
Department of Growth and Reproduction & EDMaRC, University of Copenhagen, Copenhagen, Denmark.
Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Pediatr Res. 2016 Oct;80(4):526-30. doi: 10.1038/pr.2016.125. Epub 2016 Jun 3.
Appearance of glandular breast tissue may be difficult to distinguish from fat tissue by palpation, especially in obese girls. To our knowledge, validation of the clinical assessment of pubertal breast stages by magnetic resonance imaging (MRI) has never been performed. Our objective was to report normative data of glandular breast tissue volume and validate the clinical evaluation of pubertal breast staging by MRI of breast tissue and to evaluate circulating reproductive hormone levels and estrogen-dependent transabdominal ultrasound (TAUS) parameters as markers of glandular breast tissue.
Glandular breast tissue volume quantified by MRI and breast stage evaluation was performed in 100 healthy peripubertal girls. Circulating levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, and estradiol were measured by immunoassays. Ovarian volume, uterine volume, and endometrial thickness were assessed by TAUS.
Glandular breast tissue volume was positively associated with Tanner stages (r = 0.858, P < 0.001). The sensitivity and specificity of breast palpation to detect presence of glandular breast tissue using MRI as gold standard were 96 and 95%, respectively. The best parameters to distinguish prepubertal girls from girls with breast development were: LH (area under the curve (AUC) by receiver operating characteristic analysis = 0.871), inhibin B (AUC = 0.847) and estradiol (AUC = 0.830).
Clinical palpation reliably detects the presence of glandular breast tissue.
通过触诊可能难以区分乳腺组织与脂肪组织，尤其是在肥胖女孩中。据我们所知，从未通过磁共振成像（MRI）对青春期乳房分期的临床评估进行过验证。我们的目的是报告乳腺组织体积的标准数据，通过乳房组织MRI验证青春期乳房分期的临床评估，并评估循环生殖激素水平和雌激素依赖性经腹超声（TAUS）参数作为乳腺组织的标志物。
对100名健康的青春期前女孩进行了通过MRI量化的乳腺组织体积和乳房分期评估。通过免疫测定法测量促卵泡激素（FSH）、促黄体生成素（LH）、抑制素B和雌二醇的循环水平。通过TAUS评估卵巢体积、子宫体积和子宫内膜厚度。
乳腺组织体积与坦纳分期呈正相关（r = 0.858，P < 0.001）。以MRI作为金标准，乳房触诊检测乳腺组织存在的敏感性和特异性分别为96%和95%。区分青春期前女孩与乳房发育女孩的最佳参数为：LH（通过受试者操作特征分析的曲线下面积（AUC）= 0.871）、抑制素B（AUC = 0.847）和雌二醇（AUC = 0.830）。
临床触诊能够可靠地检测出乳腺组织的存在。
