Effectiveness of Pelvic Ultrasound in the Diagnosis of Central Precocious Puberty and Differentiation from Similar Conditions

Purpose:
This study was conducted with the aim of investigating the use of pelvic ultrasound and its parameters in differentiating CPP patients from similar conditions (isolated premature thelarche (IPT) and isolated premature adrenarche (IPA)) and healthy girls.
Methods:
We consecutively enrolled 183 cases from 2015 to 2019 years in different groups based on the case-control method who were referred to the Endocrinology department of Ali Asghar hospital for evaluation of precocious puberty. All cases were of Persian ethnicity, classified by clinical and laboratory findings. Pelvic ultrasonography was evaluated in all groups. A one-way analysis of variance (ANOVA) was used to compare the mean of continuous variables. Finally, Receiver– operating characteristics (ROC) analysis was used to determine the best cut-off point for ultrasonography parameters
Results:
Among a total of 183 children, 62 were classified as the control (33.87%), 93 as the CPP group (50.81%), 16 as the IPT group (8.74%), and 12 as the IPA group (6.55%). Our study shows no significant difference in chronological age and BMI of classified groups, but CPP group showed a significantly higher bone age (107.76±19.81 month) (p<0.001) and taller height (129.53±8.97 cm) (p=0.003) against other groups. All ultrasonography parameters differ significantly between CPP and control group, also a significant difference is found between CPP compared to IPT and IPA patients in all parameters except in cervix anteroposterior diameter, and ovarian volumes. The best parameters for differentiating CPP compared to study groups were uterine volume (a cut-off of 1.40, 75.27% sensitivity,75.56% specificity), transverse diameter (a cut-off of 13.5 mm, 72.04% sensitivity, 71.11% specificity), and F/C (fundus/cervix) ratio (a cut-off of 0.98, 78.49% sensitivity, 70% specificity).
Conclusion:
Pelvic ultrasound parameters may improve the diagnosis of CPP patients and can play an
auxiliary role in distinguishing the treatment needed from other patients.