The role of gynecologic sonography in sexual development assessment of girls and adolescents.

INTRODUCTION AND

OBJECTIVES

Transabdominal ultrasonography (US) is the technique of choice for pelvis evaluation in paediatric population. The results of studies regarding US findings show a wide variation. The objectives of our study were: to estimate and correlate uterine and ovarian ultrasound measures (longitudinal diameter and volume) with chronological age, breast Tanner stage (TS) and gynaecological age (GA); to evaluate presence and size of follicles in patients according to their pubertal stage; and to determine the endometrial length in prepubertal and pubertal girls.

MATERIAL AND

METHODS

Unicentric, observational, retrospective, analytical study, conducted between 2010 and 2019. Healthy girls between 8.0 and 16.0 years, attended in the deparment of radiology were evaluated. Breast Tanner's stage (TS) was evaluated and gynaecological age was determined. Ultrasounds were performed by a paediatric diagnostic radiospecialist. Uterus length (UL) and ovarian length (OL) were measured; uterus and ovarian volume were calculated (UV and OV). Diameter of the largest follicle and endometrial thickness were measured.

RESULTS

292 patients were analyzed, mean age was 12.5 years (SD: 2.1). A significant correlation was observed between uterine and ovarian measurements with chronological age (CA), TS and GA (p < 0.0001). A significant increase in DLU and VU is described as the CA intervals increase, also in ovarian measurements. No significant differences in measurements were observed between TS I and II. An increase was evidenced at menarche. In 30.9% of pubertal patients and 11.8% of prepubertal patients showed ovarian follicles. The endometrium was not measurable in 88.24% of the pre-pubertal population and was always measurable in patients with TS IV and V.

CONCLUSIONS

Uterine and ovarian measurements increased with CE and ET (except ETI and II). The greatest increase occurred with menarche. Ovarian follicles and endometrium thickness less than or equal to 1 mm were presented in prepubertal patients.