女童性早熟的超声诊断应用研究

Application of ultrasound in diagnosis of girl precocious puberty

目的研究女童不同类型性早熟敏感性及特异性较高的超声参数,寻求超声在女童性早熟诊断中的应用价值。方法 2016年2月-2018年2月,收集性早熟女童263例,其中,中枢性性早熟组(CPP组)146例,外周性性早熟组(PPP组)117例。另选择正常女童146例,均检测子宫、卵巢及乳腺腺体情况,超声多参数测量数据进行比较,观察不同类型性早熟患儿组之间及其与正常女童各项超声参数的差异与特征。结果宫颈厚是诊断CPP的最佳诊断指标,临界值为0.75cm,乳腺腺体厚是特异度最高的指标,临界值为1.03cm,二者联合,诊断的灵敏度为92.1%,特异度为96.3%;宫颈长度是PPP的最佳诊断指标,临界值为1.51cm,宫体体积是特异度最高的指标,临界值为2.87cm^3,二者联合,诊断的灵敏度为90.1%,特异度为95.4%;卵巢体积是区分CPP与PPP的最佳诊断指标,临界值为2.25cm^3,乳腺腺体长度是特异度最高的指标,临界值为3.67cm,二者联合,诊断的灵敏度为93.5%,特异度为89.2%。结论超声检查无创、可靠,其超声测量参数在女童性早熟的临床诊断与鉴别中有者较高的应用价值。

Objective To study the sensitivity and specificity of ultrasound parameters for diagnosing girls with different types of precocious puberty,and to explore the value of ultrasound in the diagnosis of girls＇precocious puberty. Methods There were 263 girls with precocious puberty,including 146 in the Central Precocious Puberty（CPP）group,117 in the Peripheral Precocious Puberty（PPP）group,and 146 normal girls from February 2016 to February 2018.The uterus,ovaries,and mammary glands were detected.Ultrasonic multi-parameter measurement data were compared to observe the differences and features of ultrasound parameters among children with different types of precocious puberty and their children with normal girls. Results Cervical thickness was the best diagnostic indicator for diagnosing CPP,the critical value was 0.75 cm,the highest specificity index was the thickness of the mammary gland with a critical value of 1.03 cm,and the combination of the two had a diagnostic sensitivity of 92.1% and a specificity of 96.3%.The length of the cervix was the best diagnostic indicator of PPP,the critical value was 1.51 cm,the highest specificity index was the volume of the uterine body,the critical value was 2.87 cm^3,and the combination of the two had a diagnostic sensitivity of 90.1%and a specificity of 95.4%.Ovarian volume was the best diagnostic indicator to distinguish between CPP and PPP,the critical value was2.25 cm^3,the highest specificity index was the breast gland length,the critical value was 3.67 cm,and the combination of the two had a diagnostic sensitivity of 93.5% and a specificity of 89.2%. Conclusion Ultrasound examination is non-invasive and reliable,and its ultrasound measurement parameters have high application value in the clinical diagnosis and identification of girls＇precocious puberty.