Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Usefulness of pelvic ultrasonography for the diagnosis of central precocious puberty in girls

  • Yu, Jung (Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Shin, Ha Young (Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Sun Hee (Department of Pediatrics, Gil Medical Center, Graduate School of Medicine, Gacheon University of Medicine and Science) ;
  • Kim, You Sung (Department of Radiology, Inje University Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Jae Hyun (Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine)
  • 투고 : 2014.08.21
  • 심사 : 2014.10.20
  • 발행 : 2015.08.10
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초록

Purpose: It is difficult to differentiate between central precocious puberty (CPP) and premature thelarche (PT) in girls. The aim of this study was to investigate the diagnostic usefulness of pelvic ultrasonography to distinguish between CPP and PT in girls with early breast development. Methods: This study included girls with early breast development who visited the clinic between January 2012 and December 2013. Clinical, laboratory, and pelvic ultrasonographic data were evaluated. CPP and PT were confirmed using the gonadotropin-releasing hormone stimulation test. Results: A total of 248 girls aged 7-8 years were included, among whom 186 (75.0%) had CPP and 62 (25.0%) had PT. The uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger in the CPP group (uterine length, $2.45{\pm}0.50cm$ vs. $2.63{\pm}0.49cm$, P=0.015; uterine volume, $0.95{\pm}0.62cm^3$ vs. $1.35{\pm}0.76cm^3$, P<0.001). However, there were no differences in the fundus/cervix ratio and ovarian measurements. In receiver operating characteristic analysis, a uterine volume of at least $1.07cm^3$ was the most predictive parameter for CPP with an area under the curve of 0.670 (95% confidence interval, 0.593-0.747). Conclusion: Uterine measurements by pelvic ultrasonography in girls with early pubertal development were significantly larger in the CPP group. However, the diagnostic value of ultrasonographic parameters was not high because of a considerable overlap of values between the two groups. Therefore, pelvic ultrasonography in combination with clinical and laboratory tests may be useful to distinguish between CPP and PT in girls.

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참고문헌

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피인용 문헌

  1. Basal serum luteinizing hormone value as the screening biomarker in female central precocious puberty vol.24, pp.3, 2019, https://doi.org/10.6065/apem.2019.24.3.164
  2. Rapid progressive central precocious puberty: diagnostic and predictive value of basal sex hormone levels and pelvic ultrasound vol.33, pp.6, 2020, https://doi.org/10.1515/jpem-2019-0577