特发性中枢性性早熟和单纯乳房早发育女童乳腺和盆腔超声比对研究

doi:10.3969/j.issn.1007-3205.2020.11.015

河北医科大学学报 ›› 2020, Vol. 41 ›› Issue (11): 1311-1316.doi: 10.3969/j.issn.1007-3205.2020.11.015

特发性中枢性性早熟和单纯乳房早发育女童乳腺和盆腔超声比对研究

1.河北大学附属医院儿科，河北保定 071000；2.河北医科大学第二医院儿科，河北石家庄 050000；
3.河北省保定市第二医院检验科，河北保定 071000；4.河北省保定市儿童医院儿科，河北保定 071000

出版日期:2020-11-25 发布日期:2020-11-30
作者简介:袁博（1980-），女，河北保定人，河北大学附属医院主治医师，医学硕士，从事儿科内分泌疾病诊治研究。
基金资助:
2016年河北省政府资助省级临床医学优秀人才项目；河北省科学技术研究与发展项目（09276102D-1）;保定市科技计划项目（18ZF058）

Ultrasound assessment of breast and pelvic: distinction between premature thelarche and idiopathic central precocious puberty

1.Department of Pediatrics, Affiliated Hospital of Hebei University, Baoding 071000, China;
2.Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang
050051, China; 3.Department of Clinical Laboratory, the Second Hospital of Baoding,
Hebei Province， Baoding 071000, China; 4.Department of Pediatrics, Baoding
Children′s Hospital, Hebei Province， Baoding 071000,China

Online:2020-11-25 Published:2020-11-30

摘要/Abstract

摘要： 目的探讨不同发育阶段的女童乳腺和盆腔超声的影像学参数变化特征以及对特发性中枢性性早熟（idiopathic central precocious puberty，ICPP）、单纯乳房早发育(premature thelarche，PT)女童的诊断和鉴别诊断意义。
方法选择青春发育阶段女童124例为研究对象，测量身高、体重；拍摄骨龄片、测性激素、做盆腔及乳腺超声，并进行乳腺超声分级评估。根据性早熟的年龄（8岁前出现乳房发育）界定，从中筛选出达到性早熟年龄界定的女童54例，最终确诊16例ICPP组和38例 PT组，比较2组间第二性征、盆腔超声参数及乳腺超声分级的差异。
结果 24例受试女童按乳腺超声分级，A级34例（27.4%）、B级49例（39.5%）、C级18例（14.5%）、D级5例（4%）、E级18例（14.5%）。各级间年龄、体重指数（body mass index，BMI）、子宫体积、子宫长径、子宫前后径/宫颈前后径值（uterus/anterior-posterior diameter of cervix，FCR）、最大卵巢体积、子宫内膜厚度、阴道壁厚度、≥4 mm卵泡数、最大卵泡直径、乳芽直径及乳芽体积均差异有统计学意义（P＜0.05）。受试者中ICPP 16例，PT 38例，2组间年龄、子宫体积、子宫长径、子宫内膜厚度、最大卵巢体积、≥4 mm卵泡数、最大卵泡直径、乳芽直径及乳芽体积差异均有统计学意义（P＜0.05），BMI、FCR值及阴道壁厚度差异均无统计学意义（P＞0.05）。16例ICPP受试者乳腺超声分级为：A级1例（6.3%），B级13例（81.2%），C级2例（12.5%）。38例PT受试者乳腺超声分级为： A级18例（47.4%），B级18例（47.4%），C级2例（5.2%），组间乳腺超声分级差异有统计学(P＜0.05)。
结论乳腺超声分级可用于评估女童青春期发育。乳腺、盆腔超声和乳腺超声分级对于女童ICPP和PT间均有一定诊断及鉴别诊断价值。

关键词: 乳腺, 人；超声检查；青春期, 早熟

Abstract: Objective To explore the imaging features of ultrasound in girls at different developmental stages and their ability to distinguish idiopathic central precocious puberty from premature thelarche.
Methods We performed a retrospective study with a sample of 124 girls, who underwent ultrasound for evaluation development. We evaluated breast ultrasound grade, breast and pelvic ultrasound, and clinical characteristics including age and body mass index. Among the 124 girls, 52 were up to 9 years old with early breast development. We divided them into idiopathic central precocious puberty(16 cases), and premature thelarche groups(38 cases) and evaluated the clinicoradiologic findings for each group.
Results A total 124 girls were graded by breast ultrasound grade, including 34 cases of grade A(27.4%), 49 cases of grade B(39.5%), 18 cases of grade C(14.5%), 5 cases of grade D(4%) and 18 cases of grade E(14.5%). There were statistical differences in age, BMI, uterine volume, uterine length diameter, anterior-posterior diameter of uterus/anterior-posterior diameter of cervix(FCR), maximum ovarian volume, endometrial thickness, vaginal wall thickness, number of ≥4 mm follicles, maximum follicular diameter, breast bud diameter and breast bud volume for girls(P＜0.05). There were 16 cases of ICPP and 38 cases of PT. The age, uterine volume, uterine length, endometrial thickness, maximum ovarian volume, ≥4 mm follicle number, maximum follicle diameter, breast bud diameter and breast bud volume of girls between ICPP and PT groups were statistically different(P＜0.05), while BMI, FCR value and vaginal wall thickness were not statistically different(P＞0.05). The breast ultrasound grade of 16 ICPP subjects were as follows: grade A in 1 case(6.3%), B in 13 cases and （81.2%), C in 2 cases(12.5%); breast ultrasound grade in 38 PT subjects was grade A in 18 cases(47.4%), B in 18 cases(47.4%), C in 2 cases(5.2%). There was statistical difference in breast ultrasound grading between two groups(P＜0.05).
Conclusion 〖JP2〗It was shown that the ultrasonographic staging of breast development could provide more accurate and objective data.Ultrasound has the ability to distinguish idiopathic central precocious puberty from premature thelarche. 〖JP〗

Key words: , mammary glands, human； ultrasonography； puberty, precocious

袁博, 皮亚雷, 张亚男, 田莹珺, 常洁, 张会丰. 特发性中枢性性早熟和单纯乳房早发育女童乳腺和盆腔超声比对研究[J]. 河北医科大学学报, 2020, 41(11): 1311-1316.

YUAN Bo, PI Ya-lei, ZHANG Ya-nan, TIAN Ying-jun, CHANG Jie, ZHANG Hui-feng. Ultrasound assessment of breast and pelvic: distinction between premature thelarche and idiopathic central precocious puberty[J]. Journal of Hebei Medical University, 2020, 41(11): 1311-1316.

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特发性中枢性性早熟和单纯乳房早发育女童乳腺和盆腔超声比对研究

Ultrasound assessment of breast and pelvic: distinction between premature thelarche and idiopathic central precocious puberty

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