scholarly journals Ultrasonographic and clinical parameters for early differentiation between precocious puberty and premature thelarche

2006 ◽  
Vol 154 (6) ◽  
pp. 891-898 ◽  
Author(s):  
Liat de Vries ◽  
Gadi Horev ◽  
Michael Schwartz ◽  
Moshe Phillip
Keyword(s):  
Precocious Puberty ◽  
Clinical Laboratory ◽  
Early Stage ◽  
Standard Deviation Score ◽  
Bone Age ◽  
Stimulation Test ◽  
Transverse Diameter ◽  
Pelvic Ultrasound ◽  
Premature Thelarche ◽  
Uterine Volume

Objective: To determine if uterine and ovarian measurements can significantly distinguish between precocious puberty (PP) and premature thelarche (PT) and whether ultrasound has any advantage over the gonadotropin-releasing hormone (GnRH) stimulation test. Design: Prospective. Methods: One hundred and three girls referred consecutively for evaluation of breast budding before age 8 years underwent physical examination, GnRH stimulation test, bone age assessment, and transabdominal pelvic ultrasound. The diagnosis of PP or PT was based on clinical judgment. The clinical, laboratory, and ultrasound data of the PP and PT groups were compared. Results: Eighty-one girls were diagnosed with PP and 22 with PT. Significant differences in most of the uterine and ovarian measurements were found between the groups. On logistic regression analysis, bone age standard deviation score, uterine transverse diameter, and uterine volume were the most significant variables predicting PP. Comparison of 30 girls with PP and 21 with PT in whom peak luteinizing hormone was <5 mIU/ml on the GnRH stimulation test, using analysis of variance, yielded significant differences in uterine width (P<0.001), fundus diameter (P <0.04), uterine volume (P= 0.006), and ovarian circumference (P <0.02). Conclusions: Increased uterine and ovarian measurements may be an early and sensitive sign of PP. Pelvic ultrasound, a noninvasive, inexpensive, and reliable tool, may give the clinician a complementary indication to the GnRH test in distinguishing isolated PT from early-stage PP in girls with early breast budding.

scholarly journals Diagnostic Efficacy of Pelvic Ultrasound in Central Precocious Puberty in Girls: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Elham Zarei ◽  
Nima Rakhshankhah ◽  
Mahmoud Khodadost ◽  
Abolfazl Abouie ◽  
Kosar Mohammadnejad ◽  
...  
Keyword(s):  
Precocious Puberty ◽  
Central Precocious Puberty ◽  
Study Groups ◽  
Diagnostic Value ◽  
Transverse Diameter ◽  
Diagnostic Parameter ◽  
Premature Thelarche ◽  
Anteroposterior Diameter ◽  
Isolated Premature Thelarche ◽  
Uterine Volume

Abstract Background: Differentiating central precocious puberty (CPP) patients from normal cases and CPP-like patients “isolated premature thelarche (IPA) and isolated premature thelarche (IPT)” is important for beginning of treatment. Although the GnRH stimulation test is considered the gold standard for diagnosis of CPP, Because of its wide limitations, our study targets to evaluate pelvic sonography parameters as a contributory tool for CPP diagnosis.Methods: We consecutively enrolled 183 cases (93 CPP, 16 IPT, 12 IPA and 62 of age-matched normal controls) in our study over four years. All cases are classified by clinical and laboratory findings and are followed up for at least 2 years. Pelvic sonography parameters included uterine fundus, body and cervix anteroposterior diameter, fundus/cervix ratio, uterine length and transverse diameter, uterine volume, endometrial thickness, ovarian volumes and diameter of the largest follicle are evaluated in all classified groups. One-way ANOVA, post hoc and receiver operating characteristic (ROC) analysis was used to compare the study groups.Results: Our study found that all sonography parameters differ significantly between CPP and normal control cases, also a significant difference is found between CPP compared to IPT or IPA cases in all parameters except in cervix anteroposterior diameter, ovarian volumes and diameter of the largest follicle. In order of best parameters for differentiating CPP compared to study groups, uterine volume (a cut-off of 1.40 ml had a sensitivity of 75.27% and a specificity of 75.56%), transverse diameter (a cut-off of 13.5 mm had a sensitivity of 72.04% and a specificity of 71.11%) and F/C ratio (a cut-off of 0.98 had a sensitivity of 78.49% and a specificity of 70%) was selected. Our study also classified sonography parameters as in equal diagnostic value to uterine volume (as the best diagnostic parameter with area under the curve of 0.826) and not equal diagnostic value to uterine volume.Conclusions: Pelvic Sonography parameters may improve the diagnosis of CPP patients and can have a contributory role in distinguishing treatment needed patients from other patients. The best diagnostic parameter and its cut-off value could change according to different ethnicities and studies.

Rapid progressive central precocious puberty: diagnostic and predictive value of basal sex hormone levels and pelvic ultrasound

2020 ◽  
Vol 33 (6) ◽  
pp. 785-791
Author(s):  
Valeria Calcaterra ◽  
Catherine Klersy ◽  
Federica Vinci ◽  
Corrado Regalbuto ◽  
Giulia Dobbiani ◽  
...  
Keyword(s):  
Precocious Puberty ◽  
Tanner Stage ◽  
Central Precocious Puberty ◽  
Bone Age ◽  
Diagnostic Value ◽  
Sex Hormone ◽  
Pelvic Ultrasound ◽  
Predictive Values ◽  
Hormone Levels ◽  
Ultrasound Parameters

AbstractObjectivesData on the predictive values of parameters included in the diagnostic work-up for precocious puberty (PP) remain limited. We detected the diagnostic value of basal sex hormone levels, pelvic ultrasound parameters and bone age assessment for activation of the hypothalamic-pituitary-gonadal axis in girls with PP, in order to help in the decision to perform GnRH testing.Patients and methodsWe retrospectively considered 177 girls with PP. According to puberty evolution, the girls were divided into two groups: rapid progressive central precocious puberty (RP-CPP) and non/slowly progressive/transient forms (SP-PP). In all patients we considered Tanner stage, basal luteinizing hormone (LH) and estradiol (E2) values, bone age, and pelvis examination. We assessed the diagnostic value of each variable and identified the number of pathological parameters that best identify patients with RP-CPP.ResultsBasal LH ≥ 0.2IU/L, E2 level ≥ 50 pmol/L, uterine longitudinal diameter ≥ 3.5 cm, transverse uterine diameter ≥ 1.5 cm, endometrial echo and ovarian volume ≥ 2 cm3 were significantly associated with RP-CPP (p ≤ 0.01). The ability to diagnose RP-CPP was enhanced with increasing number of pathological hormonal and instrumental parameters (p < 0.001). With more than three parameters detected, sensitivity and specificity reached 58% (95%CI 48–67) and 85% (95%CI 74–92), respectively, with a PPV = 86% (95%CI 76–93) and PPN = 54% (95%CI 43–54); the area under the ROC curve was 0.71 (95%CI 0.65–0.78).ConclusionDespite the availability of different tests, diagnosing RP-CPP remains difficult. A diagnosis model including at least three hormonal and/or ultrasound parameters may serve as a useful preliminary step in selecting patients who require GnRH testing for early detection of RC-PP.

Assessment of gonadotropin concentrations stimulated by gonadotropin-releasing hormone analog by electrochemiluminescence (ECLIA) in girls with precocious puberty and premature thelarche

2021 ◽  
Author(s):  
Kamila Botelho Fernandes de Souza ◽  
Melyna Shayanne Pessôa Veiga ◽  
Gabriela Ráina Ferreira Martins ◽  
Adriana Paula da Silva ◽  
Lívia Grimaldi Abud Fujita ◽  
...  
Keyword(s):  
Precocious Puberty ◽  
Central Precocious Puberty ◽  
Bone Age ◽  
Gonadotropin Releasing Hormone ◽  
Assay Method ◽  
Premature Thelarche ◽  
Releasing Hormone ◽  
Cutoff Values ◽  
Hormone Analog ◽  
Hormone Analogs

Objective: The aim of this study is to determine the cutoff values of gonadotropin response to gonadotropin-releasing hormone analogs (GnRHas) corresponding to the activation of the hypothalamic–pituitary–gonadal axis that could differentiate central precocious puberty (CPP) from premature thelarche (PT) and using the electrochemiluminescence assay method. Methods: A total of 49 girls underwent the stimulation test with the intramuscular injection of 3.75 mg leuprolide acetate. Based on the clinical and laboratory characteristics, they were divided into two groups: CPP (n = 22) and PT (n = 27). Baseline estradiol, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were collected before GnRHa administration, and LH and FSH at 60 and 120 min, respectively, after GnRHa administration. Results: The girls with CPP presented an increased height Z-score, advanced bone age, and higher baseline LH, FSH, estradiol, and LH/FSH ratio in relation to PT (p < 0.001). Stimulated LH differed significantly between the two groups, and the LH cutoff values were ≥4.29 IU/L (p < 0.001) and ≥3.95 IU/L at 60 and 120 min, respectively (p < 0.001). LH peak was found at 60 min after stimulation. Conclusions: The GnRHa test is effective in distinguishing CPP from PT, and a single sampling, at 60 min, with LH concentrations above 4.29 may be the parameter of choice with the advantage of greater convenience and practicality.

scholarly journals Ovarian cysts and tumors as the cause of isosexual pseudoprecocious puberty

2006 ◽  
Vol 134 (7-8) ◽  
pp. 305-309 ◽  
Author(s):  
Katarina Mitrovic ◽  
Dragan Zdravkovic ◽  
Tatjana Milenkovic ◽  
Katarina Sedlecki ◽  
Zoran Stankovic
Keyword(s):  
Luteinizing Hormone ◽  
Granulosa Cell ◽  
Precocious Puberty ◽  
Granulosa Cell Tumor ◽  
Central Precocious Puberty ◽  
Bone Age ◽  
Cell Tumor ◽  
Ovarian Cysts ◽  
Pelvic Ultrasound ◽  
Releasing Hormone

Introduction. Precocious puberty in girls is generally defined as appearance of secondary sexual characteristics before eight years of age. Menarche before the ninth birthday may serve as an additional criterion. Precocious puberty is divided in central precocious puberty and pseudoprecocious puberty. Central precocious puberty (GnRH dependent) occurs because of premature activation of hypothalamic-pituitarygonadal axis and activity of gonadotrophins. Pseudoprecocious puberty (GnRH independent) is caused by activity of sexual steroids that are not the result of gonadotrophin activity. Objective. Objective of our study was to examine the etiology, clinical and laboratory manifestations of isosexual pseudoprecocious puberty in girls. Method. In the period between 1995 and 2004, clinical and laboratory sings of 34 girls with precocious puberty were studied at the Endocrine Department of the Institute of Mother and Child Health Care of Serbia. Initial evaluations included height measurement, staging of puberty, bone age assessment and pelvic ultrasound. Important diagnostic sonographic parameters of precocious puberty were the volumes of ovaries and uterus as well as ovarian structure. The initial hormonal evaluation included measuring of plasma oestradiol, luteinizing hormone (LH) and follicle stimulating hormone (FSH). The luteinizing hormone releasing hormone (LHRH) stimulation test was used to evaluate LH and FSH responsiveness (60 ?g/m2 LHRH- Relefact LHRH?, Ferring). Blood samples were collected at 0, 20 and 60 minutes. Basal and GnRH stimulated LH and FSH were determined by immunoradiometric assay. Estradiol concentration was measured using the fluoroimmunometric assay. Results. Thirty-four girls aged 6 months to 9 years (mean age 4.5 years) with precocious puberty were studied during the period of 9 years. Eleven girls presented with breast development, six with vaginal bleeding and seventeen with signs of puberty. On the basis of clinical signs, bone age, estradiol levels and LHRH test, premature the larche was diagnosed in eleven patients (32.4%), premature menarche in six (17.6%) and central precocious puberty in ten girls (29.4%). Seven girls (20.6%) presented with pseudoprecocious puberty. Pelvic ultrasound examination revealed unilateral ovarian cysts in six patients and granulosa cell tumor in one. Elevated estrogen serum levels and failure of gonadotropin responses after gonadotropin releasing hormone were the classical findings in patients with isosexual pseudoprecocious puberty during the acute period of disease. In four patients, the cyst decreased spontaneously after several months, while in two patients, the cyst was removed by laparotomy. Surgical treatment was performed in a patient with granulosa cell tumor. Conclusion. Our work demonstrates that autonomous functional ovarian follicle cyst is the most often cause of isosexual pseudoprecocious puberty. Short period of observation is suggested because the cyst can resolve spontaneously. On the other hand, juvenile granulosa cell tumor, as highly malignant tumor, should be removed as soon as diagnosis is established.

scholarly journals A diagnostic model of idiopathic central precocious puberty based on transrectal pelvic ultrasound and basal gonadotropin levels

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093527
Author(s):  
Bo Yuan ◽  
Ya-Lei Pi ◽  
Ya-Nan Zhang ◽  
Peng Xing ◽  
He-Meng Chong ◽  
...  
Keyword(s):  
Luteinizing Hormone ◽  
Precocious Puberty ◽  
Endometrial Thickness ◽  
Central Precocious Puberty ◽  
Diagnostic Model ◽  
Transverse Diameter ◽  
Pelvic Ultrasound ◽  
Ovarian Volume ◽  
Idiopathic Central Precocious Puberty ◽  
Anterior Posterior

Objective To establish a diagnostic model of idiopathic central precocious puberty on the basis of transrectal pelvic ultrasound and basal gonadotropin. Methods A total of 669 girls with Tanner breast development stage II were enrolled in this study from January 2015 to December 2018. The participants were divided into the ICPP group and the premature thelarche group. We analyzed various variables, including age at initial diagnosis, basal luteinizing hormone levels, the long diameter of the uterus, the transverse diameter of the uterus, the anterior–posterior diameter of the uterus, the volume of the uterus, maximum ovarian diameter, average ovarian volume, maximum ovarian volume, number of follicles (≥4 mm), maximum follicular diameter, endometrial thickness, and vaginal wall thickness. Results The following diagnostic model was established: Y=−14.123 + 0.630 × age at initial diagnosis + 1.119 × transverse diameter of the uterus + 1.278 ×  anterior–posterior diameter of the uterus + 0.637 × average ovarian volume + 1.316 × maximum ovarian diameter + 0.146 ×number of follicles ≥4 mm + 2.925 × endometrial thickness + 0.559 × basal luteinizing hormone value. The area under curve was 0.922, sensitivity was 84.9%, and specificity was 86.2%. Conclusion Basal LH levels and transrectal pelvic ultrasound should be applied together to improve the accuracy of diagnosis in ICPP.

scholarly journals Diagnostic Accuracy of Female Pelvic Ultrasonography in Differentiating Precocious Puberty From Premature Thelarche: A Systematic Review and Meta-analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Nam Nhat Nguyen ◽  
Linh Ba Phuong Huynh ◽  
Minh Duc Do ◽  
Tien Yun Yang ◽  
Meng-Che Tsai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Precocious Puberty ◽  
Stimulation Test ◽  
Cochrane Library ◽  
Operating Characteristics ◽  
Premature Thelarche ◽  
Pelvic Ultrasonography ◽  
Uterine Length

BackgroundThe gonadotropin-releasing hormone (GnRH) stimulation test is the benchmark for diagnosing precocious puberty (PP). However, it is invasive, time-consuming, costly, and may create an unpleasant experience for participants. Moreover, some overlaps may occur between PP and premature thelarche (PT) in the early stage of PP. Female pelvic ultrasonography may provide additional information to help differentiate PP from PT and subsequently initiate early treatment. In this study, we aimed to first directly compare pelvic ultrasonography parameters between PP and PT groups and secondly, investigate their diagnostic accuracy compared with the GnRH stimulation test.MethodsA systematic search of the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane Library databases was performed up to March 31, 2021. All types of studies, except for case reports and review articles, were included. The GnRH stimulation test was used to confirm PP diagnosis. Those whose organic conditions might cause PP were excluded. The mean, standard deviation, sensitivity, and specificity of each parameter were documented. Forest plots were constructed to display the estimated standardized mean differences (SMDs) from each included study and the overall calculations. A bivariate model was used to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR).ResultsA total of 13 studies were included for analysis. The SMDs (95% confidence interval – CI) in ovarian volume, fundal-cervical ratio, uterine length, uterine cross-sectional area, and uterine volume between PP and PT groups were 1.12 (0.78–1.45; p &lt; 0.01), 0.90 (0.07–1.73; p = 0.03), 1.38 (0.99–1.78; p &lt; 0.01), 1.06 (0.61–1.50; p &lt; 0.01), and 1.21 (0.84–1.58; p &lt;0.01), respectively. A uterine length of 3.20 cm yielded a pooled sensitivity of 81.8% (95% CI 78.3%–84.9%), specificity of 82.0% (95% CI 61.0%–93.0%), PLR of 4.56 (95% CI 2.15–9.69), NLR of 0.26 (95% CI 0.17–0.39), and DOR of 19.62 (95% CI 6.45–59.68). The area under the summary receiver operating characteristics curve was 0.82.ConclusionFemale pelvic ultrasonography may serve as a complementary tool to the GnRH stimulation test in differentiating PP from PT.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232427, ID: CRD42021232427.

scholarly journals Factors affecting bone maturation in Chinese girls aged 4-8 years with isolated premature thelarche

2020 ◽  
Author(s):  
Huiping Su ◽  
Zhe Su ◽  
Lili Pan ◽  
Li Wang ◽  
Zhongwei Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Standard Deviation Score ◽  
Multiple Linear Regression Model ◽  
Normal Weight ◽  
Stimulation Test ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Premature Thelarche ◽  
Independent Risk Factors ◽  
Isolated Premature Thelarche

Abstract Background: In isolated premature thelarche (IPT) girls, bone age (BA) is considered consistent with chronological age. However, some IPT girls confirmed by gonadotropin-releasing hormone (GnRH) stimulation test could show another trend. We analysed BA and possible potentiating factors in a selected group of girls aged 4-8 years with IPT. Methods: IPT girls confirmed by GnRH stimulation test aged 4-8 years hospitalized from January 2015 to April 2018 at Shenzhen Children's Hospital were included in this retrospective study. They were divided into two groups with advanced BA of 2 years as the cut-off. Body mass index (BMI) and hormone levels were the main outcome measures, and regression analysis was used to identify independent risk factors. IPT girls were divided into subgroups according to the levels of BMI standard deviation score (SDS), insulin-like growth factor-1 (IGF-1) SDS and dehydroepiandrosterone sulfate (DHEAS) SDS for comparisons of advanced BA. Results: Overall, 423 subjects were included and classified into the advanced BA group (48.7%, n=206) and control group (51.3%, n=217). The advanced BA group had significantly higher BMI SDS, serum DHEAS SDS, IGF-1 SDS, androstenedione and fasting insulin and significantly lower sex hormone binding globulin (all p<0.001). Serum IGF-1 SDS (OR=1.926, p＜0.001), BMI SDS (OR=1.427, p=0.001) and DHEAS SDS (OR=1.131, p=0.005) were independent risk factors for significantly advanced BA. In the multiple linear regression model, serum IGF-1 SDS, BMI SDS and DHEAS SDS were the strongest predictors of advanced BA, accounting for 19.3% of the variance. According to BMI, 423 patients were classified into three groups: normal weight (56.03%, n=237), overweight (19.15%, n=81) and obesity (24.82%, n=105). The proportion of advanced BA in obesity group was significantly higher than those of normal weight and overweight groups (χ2=18.088, p＜0.001). In the subgroup with normal weight, higher serum IGF-1 SDS (p=0.009) and DHEAS SDS (p=0.003) affected BA advancement independent of BMI SDS. Conclusions: Girls with IPT confirmed by GnRH stimulation test aged 4-8 years might have significantly advanced BA. Obesity was highly associated with advanced BA. Age-specific serum IGF-1 SDS and DHEAS SDS were risk factors for BA advancement independent of BMI.

scholarly journals Premature thelarche: identification of clinical and laboratory data for the diagnosis of precocious puberty

2002 ◽  
Vol 57 (2) ◽  
pp. 49-54 ◽  
Author(s):  
Thais Della Manna ◽  
Nuvarte Setian ◽  
Durval Damiani ◽  
Hilton Kuperman ◽  
Vaê Dichtchekenian
Keyword(s):  
Luteinizing Hormone ◽  
Precocious Puberty ◽  
Follicle Stimulating Hormone ◽  
Bone Age ◽  
Premature Thelarche ◽  
Luteinizing Hormone Releasing Hormone ◽  
Releasing Hormone ◽  
Hormone Stimulation ◽  
Isolated Premature Thelarche ◽  
Stimulating Hormone

PURPOSE: Two groups of girls with premature breast development were studied retrospectively. We tried to identify clinical, radiological, and hormonal parameters that could distinguish between a benign, nonprogressive premature thelarche and a true precocious puberty. METHODS: The clinical outcome of 88 girls with breast enlargement before 6.1 years of age was analyzed. Taking into account the progression of their sexual maturation, we allocated the children into 2 groups: "Isolated Premature Thelarche" (n = 63) and "Precocious Puberty" (n = 25) groups. Chronological and bone ages, height and growth velocity centiles, computerized tomography of hypothalamus-pituitary area, pelvic ultrasonography, gonadotropin response to luteinizing hormone-releasing hormone stimulation as well as basal levels of luteinizing hormone, follicle-stimulating hormone, estradiol, and prolactin were studied in both groups. Statistical analysis were performed using the Student t test to compare the sample means. Fisher's exact test and chi² test were used to analyze the nonparametric variables. RESULTS: Isolated premature thelarche most frequently affected girls younger than 2 years who presented exaggerated follicle-stimulating hormone response to luteinizing hormone-releasing hormone stimulation test. The precocious puberty group had higher initial stature, accelerated growth rate and bone age, increased uterine and ovarian volumes, high spontaneous luteinizing hormone levels by immunofluorimetric assay, as well as a high luteinizing hormone response and peak luteinizing hormone/follicle-stimulating hormone ratio after luteinizing hormone-releasing hormone stimulation. CONCLUSION: At initial presentation, girls who undergo true precocious puberty present advanced bone age, increased uterine and ovarian volumes in addition to breast enlargement, as well as an luteinizing hormone-predominant response after a luteinizing hormone-releasing hormone stimulation test.

scholarly journals Diagnostic Value of Pituitary Volume in Girls with Precocious Puberty

2020 ◽  
Author(s):  
Su Wu ◽  
Yan Yang ◽  
Yujiao Wang ◽  
Qianqi Liu ◽  
Zi-yang Zhu ◽  
...  
Keyword(s):  
Precocious Puberty ◽  
Univariate Analysis ◽  
Predictive Marker ◽  
Bone Age ◽  
Diagnostic Value ◽  
Analysis Model ◽  
Pediatric Endocrinology ◽  
Roc Curve Analysis ◽  
Premature Thelarche ◽  
Cutoff Value

Abstract Background: To date, the gonadotropin-releasing hormone (GnRH) stimulation test is still the gold standard for precocious puberty (PP) diagnosis. However, it has many disadvantages, including low sensitivity, high cost, and invasive operation. This study aims to evaluate whether magnetic resonance imaging (MRI)-derived variables, including pituitary volume (PV), could be used as diagnostic factors for PP in girls, providing a non-invasive diagnostic approach for PP.Methods: A total of 288 young female patients who presented to the Clinic of Pediatric Endocrinology for evaluation of PP from January 2015 to December 2017 were enrolled. The sample included 90 girls diagnosed with premature thelarche (PT), 133 girls determined as idiopathic central precocious puberty (ICPP), 35 early pubertal girls, and 30 normal girls. All patients received pituitary MRI examinations.Results: The largest PV and pituitary height were shown in the ICPP and pubertal groups, followed by the PT group. The receiver operating characteristic (ROC) curve analysis showed that PV is a predictive marker for ICPP, with a sensitivity of 54.10% and a specificity of 72.20% at the cutoff value of 196.01 mm3. By univariate analysis, PV was positively associated with peak luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH), age, bone age, and body mass index (BMI) (all P < 0.05). However, bone age and peak LH were the only significant predictors of PV as demonstrated by the stepwise multivariate regression analysis (Model: PV = 9.431 * bone age + 1.230 * peak LH + 92.625 [P = 0.000, R2 = 0.159]).Conclusions: The PV in the ICPP group was significantly higher than in PT and control groups, but there was no reliable cutoff value to distinguish ICPP from PT. Pituitary MRI should be combined with clinical and laboratory tests to improve the diagnostic value of PV for PP.

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