radiological evaluation of central prococious puberty

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1、RadiologicalEvaluationofRadiologicalEvaluationofCentralPrecociousPubertyCentralPrecociousPubertyStanleyRayVance,Jr.StanleyRayVance,Jr.HarvardMedicalSchoolHarvardMedicalSchoolYear3Year3RadiologyCoreClerkshipRadiologyCoreClerkshipOUTLINEOUTLINEI.Briefreviewofpuberta

2、lphysiologyBriefreviewofpubertalphysiologyII.FeaturesofprecociouspubertyFeaturesofprecociouspubertyIII.IntroductiontoourpatientIntroductiontoourpatientIV.BoneagedeterminationmethodsandBoneagedeterminationmethodsandrolesindiagnosingprecociouspubertyrolesindiagnosin

3、gprecociouspubertyV.RoleofRoleofneuroimagingneuroimaginginevaluatinginevaluatingcentralprecociouspubertycentralprecociouspubertyVI.TreatmentofcentralprecociouspubertyTreatmentofcentralprecociouspubertyPUBERTALPHYSIOLOGYPUBERTALPHYSIOLOGYHypothalamusHypothalamusPub

4、ertyisapredicableGnRHsequenceofPituitaryGlandPituitaryGlandphysiologicalandphysicalchangesthatFSH&LHisinitiatedaftertheGonadsactivationofthehypothalamic-pituitary-gonadalaxis.SexHormonesSECONDARYSEXUALSECONDARYSEXUALCHARACTERISTICSCHARACTERISTICSHypothalamusHypoth

5、alamusSexhormones(i.e.GnRHtestosteroneandPituitaryGlandPituitaryGlandestrogen)causethedevelopmentofFSH&LHsecondarysexualGonadsSexcharacteristics.Hormoneshttp://www.unsystem.org/SCN/archives/adolescents/p08.gifSECONDARYSEXUALSECONDARYSEXUALCHARACTERISTICSCHARACTERI

6、STICSHypothalamusHypothalamusWiththyroidhormoneGnRHandgrowthhormone,PituitaryGlandPituitaryGlandsexhormonespromotebonegrowthbyFSH&LHstimulatingGonadsSexchondroblaststoHormonesproliferateatthegrowthplate.Inbothgirlsandboys,estrogenclosestheplateinlateadolescence.ht

7、tp://www.unsystem.org/SCN/archives/adolescents/p08.gifSEQUENCEOFPUBERTYSEQUENCEOFPUBERTYIfpubertalchangesoccurtooearly,toolate,oroutofsequence,theclinicianshouldbesuspiciousofunderlyingpathology.http://www.merck.com/media/mmhe2/figures/MMHE2327001eps.gifPRECOCIOUS

8、PUBERTYPRECOCIOUSPUBERTYDEFINITIONDEFINITIONPubertybefore8ingirls;before9inboysPubertybefore8ingirls;before9inboysImplicationsImplicationsAccelerated