Accuracy of Doppler assessment of the uterine arteries in healthy girls for the diagnosis of pubertal onset.

Autor: Cheuiche AV; Graduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., da Silveira LG; Graduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Escott GM; Graduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Lucena IRS; Radiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Puñales M; Instituto da Criança com Diabetes and Hospital Criança Conceição, Grupo Hospitalar Conceição, Porto Alegre, Brazil., Costenaro F; Endocrine Division, Hospital Moinhos de Vento, Porto Alegre, Brazil., Kopacek C; Pediatric Endocrinology Division, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil., de Paula LP; Graduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Silveiro SP; Graduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. ssilveiro@hcpa.edu.br.; Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. ssilveiro@hcpa.edu.br.
Jazyk: angličtina
Zdroj: Endocrine [Endocrine] 2022 Apr; Vol. 76 (1), pp. 172-178. Date of Electronic Publication: 2021 Nov 30.
DOI: 10.1007/s12020-021-02948-y
Abstrakt: Purpose: To evaluate the accuracy of the uterine artery pulsatility index (PI) for the diagnosis of pubertal onset in girls.
Methods: Cross-sectional study of girls with normal pubertal development. Puberty was diagnosed by the presence of Tanner breast development score ≥2. All girls underwent pelvic ultrasound and Doppler imaging of the uterine arteries. We evaluated the uterine artery PI and uterine, endometrial, and ovarian measurements. We used ROC curves with cutoffs determined by Youden index for data analysis.
Results: We included 169 girls aged 5-16 years who underwent 202 pelvic ultrasound examinations. Prepubertal girls had a significantly higher mean PI (6.70 ± 2.15) than girls in initial puberty (4.14 ± 1.55) and in late puberty (2.81 ± 1.05) (P < 0.001 for all comparisons), which reflects a progressive increase in blood flow to the uterus with the progression of puberty. ROC curve analysis showed that the PI was able to identify the onset of puberty with a mean area under the curve of 0.838 ± 0.04 (P < 0.001), and the PI cutoff point of 5.05 had a sensitivity of 77%, specificity of 85%, positive predictive value (PPV) of 92%, and accuracy of 79%. The combination of PI < 5.05 plus uterine volume >3.75 cm³ had a sensitivity of 73%, specificity of 95%, PPV of 97%, and accuracy of 79% to detect initial puberty.
Conclusions: We found a significant reduction in the PI during pubertal development, which can possibly be a valuable noninvasive tool in the evaluation of pubertal disorders, alone or in combination with uterine and ovarian volumes.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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