Pelvic ultrasound and color Doppler findings in different isosexual precocities.
OBJECTIVE
To evaluate the role of ultrasound and color Doppler analyses in improving the differential diagnosis of pubertal precocities.


METHODS
Sixty-nine girls with premature (<8 years old) breast development and/or pubic hair growth underwent: auxological (height, weight, body mass index, skeletal maturation), hormonal (basal, gonadotropin releasing hormone (GnRH)-test, adrenocorticotropic hormone test), and sonographic (uterine and ovarian volume and endometrial echo) including color Doppler (uterine arteries) evaluations.


RESULTS
The uterine size was greater in girls with a pubertal response to the GnRH test (Group II, n = 16; 7.48 +/- 4.18 mL) than in those with a prepubertal response to the GnRH test (Group I, n = 17; 3.02 +/- 1.36 mL; P = 0.006), an isolated pubarche (Group III; n = 20; 2.58 +/- 1.32 mL; P < 0.001) or an isolated thelarche (Group IV, n = 16; 1.82 +/- 1.07 mL; P < 0.001). Endometrial echo was observed in 87.5%, 29.4% and 5% of girls, respectively, in Groups II, I and III. The Doppler analysis of the uterine arteries showed the lowest impedance to be in patients with a pubertal response to the GnRH test (Group II).


CONCLUSIONS
Sonographic and color Doppler parameters may improve the diagnosis of GnRH-dependent precocious puberty and may be useful to determine which girls need treatment.
Battaglia
C
C
III Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy. battaglia@med.unibo.it
Mancini
F
F
Regnani
G
G
Persico
N
N
Iughetti
L
L
De Aloysio
D
D
D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D018579:Patient Selection; D010388:Pelvis; D011629:Puberty, Precocious / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014599:Uterus / Q000033:anatomy & histology / Q000098:blood supply / Q000000981:diagnostic imaging
D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone