Accuracy of Doppler Assessment of the Uterine Arteries for the Diagnosis of Pubertal Onset in Girls: A Scoping Review

The uterine artery pulsatility index (PI) assessed by Doppler ultrasound reflects blood flow impedance in the vessel distal to the sampling point. We aimed to evaluate the accuracy of the uterine artery PI for the diagnosis of puberty in girls. A PRISMA-ScR-compliant scoping review was performed in the MEDLINE and Embase databases with “puberty” and “Doppler ultrasonography” as the search terms. Studies that included girls aged 0–18 years who underwent pelvic Doppler ultrasound with calculation uterine artery PI were considered eligible. Ten studies comprising 1385 girls aged 1.2–18 years were included. The selected studies were published between 1996 and 2021 and included participants from Italy, Brazil, Iran, Belgium, and Denmark. Six studies included girls who were referred for evaluation of pubertal disorders, while four studies selected only healthy girls. Nine studies found a significant difference in Doppler and PI according to pubertal stage, with PI cutoff points ranging from 2.5 to 4.6 for the diagnosis of puberty onset, with a sensitivity of 77–94%, specificity of 85–100%, and accuracy of 79–98%. Doppler assessment of the uterine arteries with PI calculation is a useful noninvasive tool in the diagnosis of secondary sexual characteristic onset in girls.