The incidence of sellar abnormalities in newly diagnosed children with central precocious puberty: a single-center...

Although magnetic resonance imaging (MRI) examination of the sellar region is an important tool for evaluating the potential causes of central precocious puberty (CPP), its value in children with CPP remains controversial. This study aimed to investigate the types and incidence of abnormal MRI findings in children with CPP at initial diagnosis and to reassess whether routine sellar MRI examination remains warranted.

A retrospective analysis was conducted on 625 children (502 girls and 123 boys) diagnosed with CPP from January 2017 to January 2025. Growth and development indicators, laboratory test results and sellar MRI image data were collected, and the number and incidence of sellar MRI findings were compared between the groups.

Among the 502 girls, 86 (17.1 %) exhibited abnormal sellar MRI findings; however, only 2 cases (0.4 %) were identified as pathological, both of which were hypothalamic hemangiomas. Among the 123 boys, 31 (25.2 %) showed abnormal findings, with no pathological brain damage detected. Boys had significantly higher positive sellar MRI rates than girls (p=0.040). The rate of MRI positivity in girls decreased with age (p<0.001). Girls diagnosed with organic CPP (OCPP) were significantly younger at diagnosis and had more advanced bone age compared to those with idiopathic CPP (ICPP) (p=0.044 and 0.014, respectively).

In Chinese children with CPP, ICPP may be predominant, and pathological lesions on sellar MRI are relatively rare. Careful consideration should be given to whether to perform sellar MRI in newly diagnosed children with CPP routinely.