■在被评估为青春期早熟的女孩中,盆腔超声(pUS)可能是预测超声检查评估和初潮(TUS-M)之间预期经过的时间的关键工具。因此,本分析旨在定义超声参数与TUS-M之间的统计关系,以确定初潮时间的最可靠预测指标。
■回顾性,多中心分析。女孩被评估为性早熟,并在转诊时表现出与青春期发病一致的超声和临床发现被认为是合格的。排除接受GnRH类似物治疗的患者,仅包括随后达到完全和自发青春期的患者,并且可以获得初潮的确切日期。总的来说,我们从五个三级护理意大利中心招募了184名女孩。
■基线内分泌评估与初潮自发达成之间的时间(月)与LH(r:-0.61)呈负相关(p<0.0001),FSH(r:-0.59),雌二醇(r:-0.52)和刺激LH值(r:-0.58)。在pUS参数中,卵巢体积(r:-0.17左,-0.30右)和子宫体与子宫颈的比率(r:-0.18)与TUS-M的相关性较差,而子宫直径(r:-0.61纵向,-0.64前后)和体积(r:-0.70)达到高度统计意义(p<0.0001)。子宫体积(UV)与TUS-M呈负对数关系,是单变量和多变量分析中月经初潮时间的最可靠预测指标(p<0.001)。ROC分析确定了最佳预测18、12和6个月内初潮发作的紫外线阈值,分别为3.76、6.02和8.80ml。
■紫外线的对数在预测被评估为青春期早熟的女孩的月经初潮时间方面显示出最佳的统计性能。因此,我们开发了一个用户友好的在线应用程序,为临床医生提供了预计在月经初潮前经过的月份的估计,基于在pUS上记录的UV。
UNASSIGNED: Among girls assessed for pubertal precocity, pelvic ultrasound (pUS) may represent a pivotal tool to predict the time expected to elapse between sonographic assessment and the onset of menarche (TUS-M). Accordingly, the present analysis is meant to define the statistical relationship between sonographic parameters and TUS-M, in order to identify the most reliable predictor of the timing of menarche.
UNASSIGNED: Retrospective, multicenter analysis. Girls assessed for sexual precocity and showing sonographic and clinical findings consistent with pubertal onset upon referral were considered eligible. Patients treated with GnRH analogues were excluded and only those who had subsequently achieved complete and spontaneous pubertal attainment and for whom the exact date of menarche was available were included. Overall, we enrolled 184 girls from five tertiary care Italian Centers.
UNASSIGNED: The time elapsed (months) between baseline endocrine assessment and spontaneous achievement of menarche showed a negative statistically significant correlation (p<0.0001) with LH (r:-0.61), FSH (r:-0.59), estradiol (r:-0.52) and stimulated LH values (r:-0.58). Among pUS parameters, ovarian volume (r:-0.17 left, -0.30 right) and uterine body-to-cervix ratio (r:-0.18) poorly correlated with TUS-M, while uterine diameters (r:-0.61 longitudinal, -0.64 anteroposterior) and volume (r:-0.70) achieved a highly statistical significance (p<0.0001). Uterine volume (UV) showed a negative logarithmic relationship with TUS-M and represented the most reliable predictor of the timing of menarche in uni- and multivariable analyses (p <0.001). ROC analyses identified the UV thresholds that best predict the onset of menarche within 18, 12 and 6 months, respectively: 3.76, 6.02 and 8.80 ml.
UNASSIGNED: The logarithm of UV shows the best statistical performance in predicting the timing of menarche in girls assessed for pubertal precocity. Accordingly, we developed a user-friendly online application that provides clinicians with an estimation of the months expected to elapse before menarche, based on the UV recorded upon pUS.