Value of pelvic sonography in the diagnosis of various forms of precocious puberty in girls

PURPOSE: To evaluate the role of pelvic sonography (US) in the diagnosis and differentiation of various forms of precocious puberty in girls, and to explore reliable cutoff points of pelvic US measurements for differentiating between these conditions. METHODS: Uterine length, uterine cross-sectional area, uterine volume, fundocervical ratio, and ovarian volumes of 143 healthy girls were compared with those of 125 girls with different forms of sexual precocity. Ovaries were morphologically classified as homogenous, paucicystic, multicystic, macrocystic, and isolated cystic. RESULTS: Almost all US measurements of girls with central precocious puberty in the 0- to 8-year age group were significantly increased compared with controls and girls with premature thelarche and adrenarche (p < 0.05, except for ovarian volumes in premature thelarche group), whereas no statistically significant difference was found in the 8- to 10-year group (p > 0.05). Ovarian morphology distributions did not differ significantly between patient subgroups, but all had more mature forms compared with controls. Due to the wide overlap between the measurements, no reliable cutoff points could be determined by charting receiver operating characteristics curves. CONCLUSIONS: Pelvic US can improve the diagnosis of central precocious puberty in girls of 0-8 years of age but provides no reliable type differentiation alone. It provides no valuable information for this diagnosis in girls of 8-10 years of age.