Journal of Ultrasound in Medicine, Vol 12, Issue 10 577-581, Copyright © 1993 by American Institute of Ultrasound in Medicine
Usefulness of ovarian volume and cysts in female isosexual precocious puberty
L. R. King, M. J. Siegel and A. L. Solomon
Mallinckrodt Institute of Radiology, St. Louis, MO 63110.
The real-time pelvic sonograms of 32 girls under 8 years old with true
isosexual precocity (23 cases), pseudosexual precocity (four cases),
premature adrenarche (four cases), and an undetermined problem (one case)
were evaluated retrospectively for ovarian volume and presence and size of
cysts. Sonographic findings were compared to those of 181 age-matched
controls to determine the best sonographic indicator of precocious puberty.
Ovarian volume was 4.6 cm3 in girls with true isosexual precocity, 4.1 cm3
in girls with pseudosexual precocity, and less than 1 cm3 in the other
patients as well as in the control population. Ovarian enlargement was
bilateral in true precocity and unilateral in pseudosexual precocity. Of
the 181 subjects in the control group, 96 (53%) had ovarian cysts, almost
all of which were small (less than 9 mm in diameter). Ovarian cysts
occurred in 22 of 32 patients (69%) with precocity. The cysts generally
were smaller than 9 mm in true isosexual precocity and larger than 9 mm in
pseudosexual precocity. In conclusion, small ovarian cysts are not specific
to precocious puberty and its various subtypes. Bilateral ovarian
enlargement appears to be a reliable indicator of true isosexual puberty,
whereas unilateral ovarian enlargement in combination with macrocysts is
suggestive of pseudosexual precocity.