Rieth K G, Comite F, Dwyer A J, Nelson M J, Pescovitz O, Shawker T H, Cutler G B, Loriaux D L
AJR Am J Roentgenol. 1987 Jun;148(6):1231-8. doi: 10.2214/ajr.148.6.1231.
True precocious puberty occurs as a result of the premature release of luteinizing hormone-releasing hormone from the hypothalamus, which stimulates the secretion of the pituitary gonadotropins, which in turn stimulate the gonadal sex steroids. The differential diagnosis of true precocious puberty includes cerebral and idiopathic categories. This differentiation, which cannot be made endocrinologically due to similarities in pituitary gonadotropin and sex steroid levels, may be facilitated by high-resolution CT. A CT study of 90 children (73 girls and 17 boys) with true precocious puberty was performed at the NIH to detect cerebral causes of their precocious puberty. Thirty-four cerebral abnormalities were demonstrated in 32 children, 16 boys and 16 girls. These included hypothalamic hamartomas (17), hypothalamic astrocytoma (one), optic chiasm lesions (six), ventricular abnormalities (eight), arachnoid cyst (one), and teratoma (one). The CT appearance of these cerebral abnormalities is discussed and related to the endocrinologic findings and natural history of true precocious puberty. A practical neuroradiologic approach to the evaluation of children with precocious puberty is presented.
真性性早熟是由于下丘脑过早释放促黄体生成激素释放激素所致，该激素刺激垂体促性腺激素的分泌，进而刺激性腺分泌性类固醇。真性性早熟的鉴别诊断包括脑部和特发性类别。由于垂体促性腺激素和性类固醇水平相似，无法通过内分泌学方法进行这种区分，高分辨率CT可能有助于鉴别。美国国立卫生研究院对90例真性性早熟儿童（73例女孩和17例男孩）进行了CT研究，以检测其性早熟的脑部病因。32例儿童（16例男孩和16例女孩）发现了34处脑部异常。这些异常包括下丘脑错构瘤（17例）、下丘脑星形细胞瘤（1例）、视交叉病变（6例）、脑室异常（8例）、蛛网膜囊肿（1例）和畸胎瘤（1例）。本文讨论了这些脑部异常的CT表现，并将其与真性性早熟的内分泌学表现及自然病史相关联。本文还介绍了一种评估性早熟儿童的实用神经放射学方法。
