Morphological Study Of Brain And Pituitary In Girls With Central Precocious Puberty

ObjectiveThis study measures the pituitary volume and surface area were on voxel level,and voxel-based morphometric measurements(VBM)and surface-based morphometry(SBM)were used to study the brain structure of central precocious puberty(CPP)girls.Analyze and conduct correlation research with clinical indicators,aiming at exploring the diagnostic value of pituitary morphological features in the diagnosis of central precocious puberty,suggesting possible new methods for imaging diagnosis of precocious puberty,and finally exploring effects of brain structure on growth and development in children with central precocious puberty.MethodsFrom October 2017 to June 2018,20 Clinically-confirmed CPP girls diagnosed according to consensus on diagnosis and treatment of central precocious puberty(version 2015)in our hospital were enrolled in this study.Another 20 Gender-aged healthy girls were enrolled as normal controls.Clinical data collected included estradiol(E2),luteinizing hormone(LH)peak and peak ratio of luteinizing hormone(LH)to follicle stimulating hormone(FSH).All participants undertook examination in GE 750W 3.0T superconducting magnetic resonance imaging scanner to acquire sagittal 3D T1-weighted images.The pituitary contour was delineated in three orthogonal planes,the pituitary was segmented and modeled,and then the volume and surface area were measured and correlated with clinical data.Combined with voxel-based morphometry and surface-based morphometry,the data were processed and statistically analyzed.The differences in structural characteristics between the two groups were analyzed.The gray matter volume of abnormal regions was extracted and analyzed with clinical data.The bilateral cerebral cortex thickness and cortical complexity of girls with central precocious puberty including fractal dimension,gyrification index and sulcus depth were analyzed for its cortical developmental features.Results(1)Compared with the normal control group,the pituitary volume and surface area of the girl in the CPP group increased significantly.The CPP girl's pituitary volume was(341.71 ±77.66)mm3,and the surface area was(288.84±37.82)mm2.The normal control group had a pituitary volume of(237.06±69.42)mm3 and the surface area was(235.26±42.61)mm2.There was no significant correlation in CPP group between pituitary volume and E2 level,LH peak or LH peak/FSH peak,yet pituitary surface cirea was positively correlated with LH peak(r=0554,p =0.011)and LH peak/FSH peak(r=0.561,p=0.010)but still no significant correlation with E2 level.(2)In the CPP group,the gray matter volume increases in the left fusiform gyrus,the right occipital lobe,the right inferior temporal gyrus,the left middle temporal gyrus,and the right cuneus,but decreases in the gray volule in the left frontal gyrus.The volume of left middle temporal gyrus was correlated with E2 level(r=0.618,P=0.004),while other brain areas with abnormal gray matter were not significantly correlated with E2 level,LH peak and LH peak/FSH peak.(3)Compared to the controls,the CPP group shows increased cortical thickness in the right lateral occipital cortex,the right fusiform gyrus,the left superior parietal lobule,inferior parietal lobule and shows reduced cortical thickness in the superior temporal gyrus,the middle temporal gyrus,the inferior temporal gyrus and the banks of superior temporal sulcus of left hemicerebrum.The CPP group shows decreased fractal dimension in right supramarginal gyrus,increased gyrification index in left middle temporal gyrus,inferior temporal gyrus and right supramarginal gyrus,superior temporal gyrus,besides,the sulcal depth decreases in sulcus around precuneus,isthmus of cingulate gyrus,posterior cingulate gyrus and increases in paracentral sulcus and precentral sulcus.Conclusion(1)The pituitary volume and surface area of CPP girls are significantly different from those of normal girls,and the initial diagnosis cof CPP can be performed by imaging measurements.(2)There are obvious abnormalities in the gray matter volume of the girls in the CPP.The thickness and complexity analysis of the cortex also showed significant differences,indicating that the early sexual maturity of the CPP girls may not only affect the body's development,but also the nervous system.