Rol de la ecografía ginecológica en la evaluación del desarrollo puberal en niñas y adolescentes

Abstract

Introduction and objectivesTransabdominal ultrasonography (US) is the technique of choice for pelvis evaluation in pediatric 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 (CA), breast Tanner stage (TS) and gynecological 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 methodsUnicentric, observational, retrospective, analytical study, conducted between 2010 and 2019. Healthy girls between 8.0 and 16.0years, attended in the department of radiology were evaluated. Breast TS was evaluated and gynecological age was determined. Ultrasounds were performed by a pediatric 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. Results292 patients were analyzed, mean age was 12.5years (SD: 2.1). A significant correlation was observed between uterine and ovarian measurements with CA, TS and GA (P<.0001). A significant increase in UL and UV is described as the CA intervals increase, also in ovarian measurements. No significant differences in measurements were observed between TSI andII. 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 TSIV andV. ConclusionsUterine and ovarian measurements increased with CA and ET (except ETI andII). The greatest increase occurred with menarche. Ovarian follicles and endometrium thickness less than or equal to 1mm were presented in prepubertal patients.