title: Ovarian and uterine sonography in healthy girls between 1 and 13 years old: correlation of findings with age and pubertal status.
abstract: OBJECTIVE
  Our objective was to correlate ovarian and uterine sonographic variables with age and pubertal status in a sample of healthy girls.
  
  
  METHODS
  In this prospective study, 139 consecutive patients between 1 and 13 years old (mean +/- SD, 6.0 +/- 3.4 years) underwent sonography and hand radiography (for bone-age determination). Pubertal development was classified according to Tanner stages (prepubertal, 5.0 +/- 2.7 years [n = 117]; pubertal, 11.2 +/- 1.2 years [n = 22]). Uterine and ovarian longitudinal, transverse, and anteroposterior diameters were measured. Uterine fundal-cervical ratio was determined. Ovaries were morphologically classified as homogeneous, paucicystic, multicystic, macrocystic, and presenting isolated cysts. A p value less than or equal to 0.05 was considered significant.
  
  
  RESULTS
  The uterus was identified in 96% of the patients (mean, 6.1 +/- 3.4 years). One ovary was visible in 93% (mean, 6.2 +/- 3.4 years), and both ovaries, in 81% (mean, 6.5 +/- 3.3 years). Neither ovary was visualized in 10 girls (mean, 2.5 +/- 2.2 years). Uterine parameters and ovarian volume were smaller in patients without thelarche (p < 0.0001). Mean ovarian and uterine size was smaller in girls until 8 years, intermediate between 9 and 11 years, and larger after 12 years (p < 0.0001). Chronologic age, bone age, and Tanner stage were correlated even before 7 years. Patients with and without thelarche presented different ovarian morphology (p = 0.01).
  
  
  CONCLUSIONS
  Uterine and ovarian growth was associated with age and puberty. Uterine length presented the best correlation with age. Multicystic ovaries seemed to be correlated with normal or premature pubertal stimuli.
authors.affiliation: Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos 2350, 90035-903, Porto Alegre, Brazil.
authors.forename: Liliane Diefenthaeler
authors.initials: LD
authors.lastname: Herter
authors.forename: Eliete
authors.initials: E
authors.lastname: Golendziner
authors.forename: José Antônio Monteiro
authors.initials: JA
authors.lastname: Flores
authors.forename: Eduardo
authors.initials: E
authors.lastname: Becker
authors.forename: Poli Mara
authors.initials: PM
authors.lastname: Spritzer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010053:Ovary / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging*