Real-time ultrasonography of the pelvic organs was performed in 140 healthy girls aged 2-18 years. The aim of this study was to define the volumes and to relate the uterine and ovarian morphological changes to chronological age and the normal pubertal development. Uterine and ovarian volumes (UV and OV) were calculated; uterine morphologic was described as prepubertal (corpus/cervix < 1) or not and the ovarian structure was classified as homogeneous (less than 3 cysts < 9mm), microcystic (4-10 cysts < 9mm), multycystic (+ 10 cysts < 9mm in diameter), polycystic (+ 10 cysts and increased stroma) and follicular (at the least one cystic area > 9mm). Prepubertal UV and OV were 1.0±0.7cm³ and 0.9+0.5cm³, respectively. We considered volumes up to 2SD (UV £ 2.5cm³ and OV £ 2cm³) as prepubertal normal standards and volumes up to 4SD (UV ³ 4cm³ and OV ³ 3cm³) as indicators of puberty. Uterine morphology, presence of endometrial echo, and ovarian structure related to sexual development (p<0.005). Homogeneous ovaries were visualized only in prepubertal girls (52%); microcystic class was the most common finding in the beginning (Tanner stage II-III, 51%) and the multicystic in the end of puberty (Tanner stage IV-V, 47%); polycystic class was found in 4-11%, and the follicular (6%) was visualized only in pubertal girls. Uterus and ovaries grow in volume throughout childhood and puberty. In the course of normal puberty the ovarian development is dynamic. It has been speculated whether girls with polycystic ovaries, by ultrasound, are at risk to develop polycystic ovary syndrome in adulthood.
Pelvic ultrasonography; Normality standards; Prepubertal; Postpubertal
