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经腹盆腔超声检查对中枢性性早熟诊断的预测价值:一项单中心观察性回顾性研究

Predictive value of transabdominal pelvic ultrasonography for the diagnosis of central precocious puberty: A single-center observational retrospective study.

作者信息

Sessa Linda, Rotunno Giulia, Sodero Giorgio, Pane Lucia Celeste, Rendeli Claudia, Maresca Giulia, Rigante Donato, Cipolla Clelia

机构信息

Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Spina Bifida Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

出版信息

Clin Pediatr Endocrinol. 2024 Oct;33(4):199-206. doi: 10.1297/cpe.2024-0025. Epub 2024 Jul 15.

Abstract

This single-center, observational, retrospective study aimed to evaluate the diagnostic accuracy of pelvic ultrasonographic parameters for detecting central precocious puberty (CPP) in a cohort of female pediatric patients undergoing gonadotropin stimulation tests. The study population consisted of 47 female patients with a suspicion of CPP. Thirty four out of 47 patients (72.34%) were subsequently diagnosed with CPP based on the current laboratory diagnostic criteria (LH peak > 5 IU/L). The ultrasonography results of 39 out of 47 patients (82.97%) were categorized as pubertal, while 31 out of 34 participants (91.17%) in the CPP group exhibited pubertal ultrasonography features. In 13 out of 47 girls (27.65%), a CPP diagnosis was ruled out; however, among these 13 patients, eight exhibited pubertal ultrasonography features suspicious of CPP. We observed a robust concordance between the GnRH test results indicative of pubertal activation and the presence of pubertal pelvic ultrasonographic features in 31 out of 34 children (91.17%). A significant correlation was found between ovarian volume and basal LH and LH/ FSH ratio, and also for basal LH, LH peak, LH/FSH ratio and peak LH/FSH ratio (p = 0.026, p = 0.011, p = 0.031, p = 0.004, respectively). Pelvic ultrasonography had a sensitivity of 91.17% and a specificity of 38.46% in differentiating CPP from premature thelarche.

摘要

这项单中心、观察性、回顾性研究旨在评估盆腔超声参数在一组接受促性腺激素刺激试验的儿科女性患者中检测中枢性性早熟(CPP)的诊断准确性。研究人群包括47名疑似CPP的女性患者。根据当前实验室诊断标准(LH峰值>5 IU/L),47名患者中有34名(72.34%)随后被诊断为CPP。47名患者中有39名(82.97%)的超声检查结果被归类为青春期,而CPP组的34名参与者中有31名(91.17%)表现出青春期超声特征。47名女孩中有13名(27.65%)被排除CPP诊断;然而,在这13名患者中,有8名表现出可疑CPP的青春期超声特征。我们观察到,在34名儿童中有31名(91.17%),表明青春期激活的GnRH试验结果与青春期盆腔超声特征之间存在高度一致性。卵巢体积与基础LH及LH/FSH比值之间存在显著相关性,基础LH、LH峰值、LH/FSH比值及峰值LH/FSH比值之间也存在显著相关性(p值分别为0.026、0.011、0.031、0.004)。盆腔超声在鉴别CPP与性早熟方面的敏感性为91.17%,特异性为38.46%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f85/11442698/20e398b53b6c/cpe-33-199-g001.jpg

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