ABSTRACT
Objective To investigate the value of ultrasound in assessing leuprorelin treatment response of girls with central precocious puberty . Methods Forty girls with central precocious puberty scheduled for leuprorelin treatment were enrolled . Ultrasound examination as well as the serum hormone level test of luteinizing hormone ( LH) and follicle stimulating hormone ( FSH) were performed prior to the treatment ,after 3 and 9 months of treatment . The correlation between uterine volume ,ovarian volume and hormone levels were analyzed . Results After 3 and 9 months of leuprorelin treatment ,both the volumes of uterus and ovary and the levels of LH and FSH were significant reduced ( all P < 0 .05) . After 3 months of leuprorelin treatment ,the reduction rate in ovarian volume was positively correlated with the reduction rate of LH and FSH ( r = 0 .335 , P = 0 .034 ; r = 0 .334 , P = 0 .035) . No correlation was found between the reduction rate of uterine volume and hormone level changes ( r = 0 .110 , P = 0 .501 ; r = 0 .257 , P =0 .109) . After 9 months of treatment ,the ovarian volume reduction rate was positively correlated with the reduction rate of LH and FSH ( r = 0 .327 , P = 0 .039 ; r = 0 .356 , P = 0 .024) ,and the uterine volume reduction rate was positively correlated with the reduction rate of LH and FSH ( r = 0 .439 , P = 0 .005 ;r =0 .433 , P = 0 .005 ) . Conclusions Leuprorelin could effectively inhibit hormone release and gonadal development in girls with central precocious puberty . Ultrasound examination , as a noninvasive and convenient method ,could dynamically monitor the volume changes of uterus and ovary ,thus reflect the development of gonadal development directly and the changes of hormone level indirectly . It could be used as a routine outpatient follow-up method after central precocious medicine treatment .
ABSTRACT
Objective To investigate the value of color Doppler ultrasonography in the differential diagnosis of benign and malignant testicular tumors in children. Methods The sonographic findings of 63 children pathologically confirmed testicular tumors were retrospectively analyzed.All children were divided into benign group and malignant group according to pathologic diagnosis. The tumor size,shape,border, echo texture,calcification and color blood flow were compared between two groups. Logistic regression analysis was employed to predict sonographic features of benign and malignant testicular tumors.Receiver operating curve (ROC) was employed to assess the diagnostic performance of sonographic features. Results Among the 63 cases of pediatric testicular tumors,42 cases were histologically confirmed as benign testicular tumors (66.7% ),and the rest 21 cases were malignant testicular tumors (33.3% ). The maximum diameter of tumor in benign tumors was significantly smaller than that in malignant tumors[(1.75 ± 0.75) cm vs (2.90 ± 1.22)cm,P =0.000].In the sonographic features,malignant testicular tumors were more likely to present with solid masses,and benign testicular tumors were more likely to be cystic or cystic-solid ( P =0.024).Calcification was more common in benign tumors than that in malignant tumors ( P =0.000).Compared with benign tumors,malignant tumors had increased blood flow on color Doppler images ( P =0.000).Logistic regression analysis indicated that flow grade was the independent prognostic factors for malignant tumor. By using Alder grade of 2 or above as threshold,the sensitivity,specificity and accuracy were 95.2%,78.6% and 84.1%,respectively. Conclusions The sonographic features vary between benign and malignant testicular tumors. Blood flow is the independent factors for predicting malignant tumor. Color Doppler ultrasonography is an important method for differential diagnosis of testicular tumors in children.