Clinical value of two-dimensional ultrasound combined with shear wave elastography in the diagnosis and treatment of central precocious puberty in boys
Objective To investigate the clinical value of two-dimensional ultrasound combined with shear wave elastography(SWE)in the diagnosis and efficacy evaluation of central precocious puberty(CPP)in boys.Methods Fifty-one CPP boys(CPP group)and 55 healthy boys(healthy control group)were selected for two-dimensional ultrasound and SWE examination.The differences of testicular volume(TV),blood flow signal,internal testicular arterial resistance index(RI)and mean testicular elastic modulus(Emean)were compared between the two groups.The correlation between TV,blood flow classification,RI and Emean and sex hormone were analyzed.Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy in CPP of two-dimensional ultrasound,SWE used alone and their combination.The changes of TV,blood flow grade,RI,Emean and sex hormone in CPP boys before and after 10 months of treatment were compared,and the therapeutic effect was evaluate.Results There were statistically significant differences in TV,blood flow classification,RI and Emean between CPP group and healthy control group(all P<0.05).Correlation analysis showed that TV,blood flow classification were positively correlated with estradiol(E2),luteinizing hormone(LH),follicle-stimulating hormone(FSH),prolactin and testosterone(all P<0.001),while Emean and RI were negatively correlated with E2,LH,FSH,prolactin and testosterone(all P<0.01).ROC curve analysis showed that the area under the curve(AUC)of TV,blood flow classification,RI and Emean used alone and their combination in the diagnosis of CPP were 0.932,0.914,0.895,0.801 and 0.975,respectively,and the AUC of combined application was the highest,and the differences were statistically significant(all P<0.05).The sensitivity and specificity were 94.1%and 90.9%,respectively.After 10 months of treatment,TV,blood flow classification grade and sex hormone of CPP boys were lower than those before treatment,and Emean and RI were higher than those before treatment,and the differences were statistically significant(all P<0.05).Conclusion Two-dimensional ultrasound combined with SWE has high diagnostic value for CPP in boys and provides valuable information for evaluating treatment efficacy.
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