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王晋, 罗红, 庞厚清, 等. 儿童至青春期子宫卵巢超声测值及超声对性早熟的诊断价值[J]. 四川大学学报（医学版）, 2019, 50(4): 583-587.
引用本文: 王晋, 罗红, 庞厚清, 等. 儿童至青春期子宫卵巢超声测值及超声对性早熟的诊断价值[J]. 四川大学学报（医学版）, 2019, 50(4): 583-587.
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WANG Jin, LUO Hong, PANG Hou-qing, et al. Ultrasound Measurement of Uterus and Ovary from Childhood to Adolescence and Ultrasound in Diagnosis of Precocious Puberty[J]. Journal of Sichuan University (Medical Sciences), 2019, 50(4): 583-587.
Citation: WANG Jin, LUO Hong, PANG Hou-qing, et al. Ultrasound Measurement of Uterus and Ovary from Childhood to Adolescence and Ultrasound in Diagnosis of Precocious Puberty[J]. Journal of Sichuan University (Medical Sciences), 2019, 50(4): 583-587.
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儿童至青春期子宫卵巢超声测值及超声对性早熟的诊断价值

Ultrasound Measurement of Uterus and Ovary from Childhood to Adolescence and Ultrasound in Diagnosis of Precocious Puberty

    摘要
  • 摘要:
    目的 分析超声结合Z-score方法对女孩各类性早熟的诊断价值。
    方法 使用超声测量3~21岁正常女性子宫、卵巢的各个测值，并建立Z-score模型。使用超声测量中枢性性早熟、外周性性早熟、单纯乳腺发育及单纯阴毛早生的女孩的子宫、卵巢各个测值，选择与年龄相关度最大者计算出它们各自的Z值，使用受试者工作特征(receiver operating curve，ROC)曲线得出最佳诊断截点值。
    结果 卵巢体积和宫体长径与年龄符合度最高。其中中枢性性早熟患儿卵巢体积、宫体长径均大于正常女孩，卵巢体积Z值的曲线下面积(area under curve，AUC)=0.940，最佳诊断截点值为Z=2.16(敏感性100%，特异性81.1%)，宫体长径Z值的AUC=0.845，最佳诊断截点值为Z=1.14(敏感性91.6%，特异性84.9%)。外周性性早熟患儿仅宫体长径大于正常女孩，宫体长径Z值的AUC=0.910，最佳诊断截点值为Z=1.06(敏感性98.0%，特异性82.0%)。单纯乳腺发育和阴毛早生患儿与正常女孩超声测值的差异无统计学意义。
    结论 超声结合Z-score方法对中枢性性早熟和外周性性早熟有一定的鉴别意义，推测该方法可用于性早熟的治疗监测。

     

    Abstract:
    Objective To analyze the diagnostic value of ultrasound combined with Z-score in various types of precocious puberty of girls.
    Methods Ultrasound was used to measure the uterus and ovary of normal girls aged between 3 and 21, and Z-score model was established. Ultrasound was used to measure the uterus and ovary of girls with central precocious puberty (CPP), peripheral precocious puberty (PPP), premature pubarche (PP), and premature thelarche (PT). The highest age-related variable was selected to calculate the Z value of the above measurements. The best diagnostic cut-off point was obtained by ROC curve.
    Results Ovarian volume and uterine body length had the best correlation with age. The ovarian volume and uterine body length of the girls with CPP were longer and larger than those in normal girls. The area under curve (AUC) of ovarian volume was 0.94 and the best diagnostic cut-off value was Z=2.16 (sensitivity 100%, specificity 81.1%). The AUC of uterine body length was 0.845 and the best diagnostic cut-off value was Z=1.14 (sensitivity 91.6%, specificity 84.9%). In the girls with PPP, only the length of uterine body was longer than that of normal girls. The AUC was 0.910 and the best diagnostic cut-off value was Z=1.06 (sensitivity 98.0%, specificity 82.0%). There was no significant difference between the girls with PP, PT and normal girls.
    Conclusion Ultrasound combined with Z value has certain significance in differentiating CPP from PPP. It is speculated that this method can be used in the treatment and monitoring of precocious puberty.

     

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