Background: Adolescents with Turner Syndrome (TS) live a difficulty related to the prospective to have spontaneous pubertal development and menarche as well as to their future fertility. These questions have relevant psychological-therapeutic implications on clinical and endocrine follow-up and represent critical points in the TS management. Some patients have spontaneous menarche and do not need estroprogestinic replacement in the first years of adolescence. This evolution is not always predictable on the basis of hormonal pattern and echographic imaging, while it is described in patients with mosaicism.Methods: We studied 17 patients with TS, age: 9-16 years, caryotype 45,X in 9 patients, mosaic in 8. We did not included TS with Y chromosome, because they underwent to gonadectomy to prevent neoplasm risk. We studied caryotype, endocrine assess (FSH, LH;Prolactin, TSH, fT3, fT4, IGF-1), pelvic imaging to determine uterine and ovarian size and to compare uterine and ovarian size evaluated by transabdominal ultrasound (US) and by Magnetic Resonance imaging (MRI). We correlated the data described by imaging and caryotype, FSH, LH, estradiol levels.Results: MRI revealed higher definition of uterine, ovarian volume and morphology, follicular volume, endometrial thickness, uterine body/neck ratio. MRI measured a bigger ovarian volume compared to US; ovarian follicles were detected by MRI not by US. The presence of a bigger ovarian volume and ovarian follicles was not related to caryotype (mosaicism vs. 45,X); two patients with a spontaneouspubertal development and menstrual cycles were 45,X. 8 patients with mosaicism did not show a spontaneous pubertal development and needed estroprogestinic replacement treatment. The presence of ovarian follicles was relieved by MRI in patients with spontaneous menarche and the persistence of menstrual cycles was related to a significant ovarian volume.Conclusions: We stress the utility of MRI in the pelvic study in the follow-up of TS to help in the decision of cryopreservation.
|Numero di pagine||0|
|Rivista||Hormone Research in Paediatrics|
|Stato di pubblicazione||Published - 2012|