特发性中枢性性早熟女孩垂体MRI参数变化及其与性激素水平的关系分析

Changes of Pituitary MRI Parameters and their Relationship with Sex Hormones in Girls with Idiopathic Central Precocious Puberty

目的 分析特发性中枢性性早熟(ICPP)女孩垂体磁共振(MRI)参数变化及其与性激素水平的关系。方法 选取2019年6月至2022年5月本院收治的ICPP女孩患者106例作为ICPP组。同期选择53例单纯乳房早发育女孩作为对照组。所有入组女孩均行下丘脑垂体MRI检查,并对垂体的冠状宽径、冠状高径、矢状前后径、矢状高径进行测量。采用免疫化学发光法检测血清促卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2),并计算LH/FSH。采用Pearson相关性分析MRI参数与性激素相关性。结果 ICPP组女孩血清E2、LH水平和LH/FSH水平高于对照组(P<0.05)。ICPP组女孩MRI检测垂体高度高于对照组(P<0.05),垂体形态Ⅰ~Ⅲ级占比低于对照组(P<0.05)。ICPP组女孩冠状高径、矢状位前后径明显高于对照组,冠状宽径低于对照组(P<0.05)。两组女孩矢状高径比较无明显差异(P>0.05)。Pearson结果显示,冠状高径、矢状位前后径与E2、LH、LH/FSH均呈正相关(P<0.05)。冠状宽径与E2、LH、LH/FSH均成负相关(P<0.05)。结论 垂休影像学参数与性激素水平具有相关性,临床可结合两者检测结果诊断ICPP。

Objective To analyze the changes of pituitary magnetic resonance imaging(MRI)parameters and their relationship with sex hormones in girls with idiopathic central precocious puberty(ICPP).Methods A total of 106 girls with ICPP admitted to the hospital were enrolled as ICPP group between June 2019 and May 2022,while 53 girls with early breast development during the same period were enrolled as control group.All underwent MRI examination of hypothalamus pituitary.The coronal wide diameter,coronal high diameter,sagittal anteriorposterior diameter and sagittal high diameter of pituitary were measured.The levels of serum follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)were detected by immunochemiluminescence method,and LH/FSH was calculated.The correlation between MRI parameters and sex hormones was analyzed by Pearson correlation analysis.Results The levels of serum E2,LH and LH/FSH in ICPP group were higher than those in control group(P<0.05).The pituitary height in ICPP group was higher than that in control group(P<0.05),and proportion of pituitary morphology at gradeⅠ~Ⅲwas lower than that in control group(P<0.05).The coronal height diameter and anteroposterior diameter in ICPP group were significantly longer than those in control group,while coronal width diameter was shorter than that in control group(P<0.05).There was no significant difference in sagittal height diameter between the two groups(P>0.05).The results of Pearson correlation analysis showed that coronal height diameter and anteroposterical diameter were positively correlated with E2,LH and LH/FSH(P<0.05),while coronal width diameter was negatively correlated with them(P<0.05).Conclusion Pituitary imaging parameters are correlated with sex hormones.Clinically,combined detection can be applied in ICPP diagnosis.