Ultrasound evaluation of female isosexual precocious puberty.

Fifty-six female children with signs of precocious puberty were examined. Adult-sized ovaries and an intermediate-sized uterus were characteristic of true sexual precocity, either idiopathic or due to a CNS lesion. Premature thelarche and premature adrenarche showed normal infantile pelvic organs, while in cases of precocious pseudopuberty, the appearances of the ovaries and uterus varied depending upon the underlying process. Large ovarian cysts and large ovaries were found in six patients with McCune-Albright syndrome. An ultrasound study is of benefit in the evaluation of female children with precocious sexual development because it can demonstrate the adult-sized ovaries of true precocious puberty, thereby distinguishing this condition from premature thelarche and premature adrenarche, and it can demonstrate specific causes of precocious sexual development, such as adrenal and ovarian tumors and ovarian cysts.