Pathological and Incidental Findings on Brain MRI in a Single-Center Study of 229 Consecutive Girls with Early or Precocious Puberty 英文参考文献.docVIP

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Pathological and Incidental Findings on Brain MRI in a Single-Center Study of 229 Consecutive Girls with Early or Precocious Puberty 英文参考文献.doc

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Pathological and Incidental Findings on Brain MRI in a Single-Center Study of 229 Consecutive Girls with Early or Precocious Puberty 英文参考文献

PathologicalandIncidentalFindingsonBrainMRIina Single-CenterStudyof229ConsecutiveGirlswithEarly orPrecociousPuberty SigneSlothMogensen1,LiseAksglaede1,AnnetteMouritsen1,KasparS?rensen1,KatharinaM.Main1, PeterGideon2,AndersJuul1* 1DepartmentofGrowthandReproduction,Rigshospitalet,FacultyofHealthSciences,UniversityofCopenhagen,Copenhagen,Denmark,2DepartmentofRadiology, Rigshospitalet,FacultyofHealthSciences,UniversityofCopenhagen,Copenhagen,Denmark Abstract Central precocious puberty may result from organic brain lesions, but is most frequently of idiopathic origin. Clinical or biochemicalfactorswhichcouldpredictapathologicalbrainMRIingirlswithCPPhavebeensearchedfor.Withtherecent declineinageatpubertalonsetamongUSandEuropeangirls,ithasbeensuggestedthatonlygirlswithCPPbelow6years ofageshouldhavebrainMRIperformed. Objective: To evaluate the outcome of brain MRI in girls referred with early signs of puberty in relation to age at presentationaswellasclinicalandbiochemicalparameters. Method:Asingle-centerstudyof229consecutivegirlswithearlyorprecociouspubertywhohadbrainimagingperformed. Weevaluatedmedicalhistory,clinicalandbiochemicalfactors,andfourgroupsweredefinedbasedontheoutcomeoftheir MRI. Results:Thirteenoutof208(6.3%)girlswithprecociouspuberty,butnoothersignofCNSsymptoms,hadapathological brainMRI.Importantly,all13girlswereabove6yearsofage,and6girlswereeven8–9yearsold.Twentygirls(9.6%)had incidental findings on brain MRI. Furthermore, 21 girls had known CNS pathology at time of evaluation. Basal LH was significantlyhigheringirlswithnewlydiagnosedCNSpathologycomparedtogirlswithanon-pathologicalMRI(p=0.025); nocutofvaluewasfoundasvaluesoverlapped. Conclusion:Ahighfrequencyof6–8yearoldgirlswithprecociouspubertyinourstudyhadapathologicalbrainMRI,which couldnotbepredictedfromanyclinicalnorbiochemicalparameters.Thus,webelievethatgirlswithprecociouspubertal developmentofcentraloriginbefore8yearsofageshouldcontinuetobeexaminedbyabrainMRI. Citation:MogensenSS,AksglaedeL,Mouri