三维超声成像用于诊断性早熟女童

目的 探讨三维超声成像在女童性早熟诊断中的应用价值。方法 对32例临床确诊为中枢性性早熟女童分别行二维、三维盆腔超声检查，记录子宫、卵巢体积，卵泡数目，最大卵泡直径及卵巢血流参数，并检测其血清黄体生成素（LH）、卵泡刺激素（FSH）基础水平及雌二醇（E₂）。比较二维与三维超声的测量参数差异，分析超声测量参数与激素水平的相关性。结果 三维超声能清晰显示子宫及卵巢内部结构，三维超声测量直径>4 mm的卵泡数目和最大卵泡直径均大于二维超声（P均<0.01），三维超声测量子宫和卵巢体积与二维超声差异均无统计学意义（P均>0.05）。三维超声卵巢彩色血流显示率为87.50%（28/32），明显优于二维超声[28.12%（9/32），P<0.01）。三维超声能量多普勒血管指数（VI）、血流指数（FI）、血管血流指数（VFI）与最大卵泡直径均呈正相关（r=0.43、0.44、0.54，P均<0.05）。三维超声测量卵巢体积、最大卵泡直径与血清LH（r=0.39、0.72）、FSH（r=0.38、0.64）呈正相关（P均<0.05）。结论 三维超声在性早熟女童中计数卵泡数目、测量最大卵泡直径及显示卵巢血供方面优于二维超声，有望在诊断女童性早熟中发挥重要作用。

Application of three-dimensional ultrasound imaging in diagnosis of precocious puberty in girls

Objective To investigate the value of three-dimensional ultrasonography (3D-US) in diagnosis of precocious puberty in girls. Methods Totally 32 girls diagnosed as central precocious were enrolled. Two-dimensional ultrasonography (2D-US) and 3D-US of pelvis were performed, and the volume of uterus and ovary, the number of follicles, the maximum follicle diameter and ovarian blood flow parameters were recorded. At the same time, the basic levels of serum luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estradiol (E₂) were detected. The parameters measured with 2D-US and 3D-US were compared, and the correlation between ultrasonic measurement parameters and hormone level was also analyzed. Results 3D-US could clearly show the internal structure of uterus and ovary. The number of follicles larger than 4 mm and the maximum follicle diameter measured with 3D-US were all greater than those with 2D-US (both P<0.01), but no significant difference of the volume of uterus nor ovary was found between 2D-US and 3D-US measurements (both P>0.05). The color blood flow display rate of ovary in 3D-US was 87.50% (28/32), significantly better than that of 2D-US (28.12%[9/32], P<0.01). 3D-US energy Doppler vascular index (VI), blood flow index (FI), blood vessel-blood flow index (VFI) were positively correlated with the maximum follicle diameter (r=0.43, 0.44, 0.54, all P<0.05). 3D-US measurements of ovarian volume and maximum follicle diameters were positively correlated with the serum LH (r=0.39, 0.72) and FSH (r=0.38, 0.64, all P<0.05). Conclusion 3D-US is superior to 2D-US in counting follicles, measuring the maximum follicle diameter and showing ovarian blood supply in precocious girls, and is expected to play an important role in the diagnosis of precocious puberty in girls.