3种儿童骨龄评估方法一致性比较研究  

A comparative study on the consistency of three methods of bone age assessment in children

作　　者：黄卫保 林剑军[1] 黄华驰 王映飞[1] 莫亚宁 翟金娜 HUANG Weibao;LIN Jianjun;HUANG Huachi;WANG Yingfei;MO Yaning;ZHAI Jinna(Department of Radiology,the Maternal and Child Health Hospital of Guangi Zhuang Autonomous Region,Nanning 530000,China)

机构地区：[1]广西壮族自治区妇幼保健院放射科,广西南宁530000

出　　处：《实用放射学杂志》2023年第4期631-634,共4页Journal of Practical Radiology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200646)。

摘　　要：目的分析3种儿童骨龄评估方法(G-P图谱法、TW-CR系列与TW-CC系列评分法)的一致性及各自特点。方法收集2~16岁被试手腕部X线平片及临床资料,选取2~14岁为骨龄研究组,再按年龄段分组。采用3种方法评估每张骨龄X线平片,并对其一致性进行统计学分析和比较。结果共纳入2695人,男、女童第1掌骨远端籽骨100%出现时间分别为15岁、13岁。男童2~9岁与女童2~9岁、14岁3种骨龄评估结果不全相等,差异有统计学意义(P<0.05)。两两比较时,男童4~9岁、女童2~9岁G-P图谱法骨龄小于TW-CR系列(P<0.05),男童2~9岁和女童2岁、5~8岁G-P图谱法骨龄小于TW-CC系列(P<0.05)。男童4岁、7~14岁和女童2岁、5~13岁TW-CR系列与C系列差异无统计学意义(P>0.05)。结论第1掌骨远端籽骨出现时间可作为骨龄评估参考。男、女童3种骨龄评估方法不能全年龄段给出等效的评估结果,建议个体化诊疗及骨龄监测时固定用同种方法随诊,可优先选2种评分法之一。Objective To compare three methods for bone age assessment in children(G-P mapping method,TW-C R and TW-C C methods)and analyze the consistency and respective characteristics.Methods The data including radiographs of the wrist and clinical information from patients aged 2 to 16 were retrospectively collected.The patients aged 2-14 were selected as the study group and then grouped by age.Each bone age tablet was evaluated by three methods,and the consistency was statistically analyzed and compared.Results A total of 2695 cases were included.The distal sesamoid bone of the first metacarpal bone formed in all boys aged 15 and girls aged 13.The results of bone age for boys aged 2-9 and girls aged 2-9 and 14 were not the same and the differences were statistically significant among three methods(P<o.05).Paired comparison showed the bone age measured by the G-P mapping method was less than that by the TW-C R method in boys aged 4-9 and girls aged 2-9(P<0.05).And the bone age measured by the G-P mapping method was less than that by the TW-C C method in boys aged 2-9,girls aged 2 and 5-8(P<0.05).The difference of bone between the TW-C R method and TW-C C method was not statistically significant for boys aged 4,7-14 and girls aged 2,5-13(P>0.05).Conclusion The time when the distal sesamoid bone of the first metacarpal bone develops can be used as a basis for bone age assessment.The three methods of bone age assessment for boys and girls in all age groups are not all consistent.One of TW methods is recommended and remains unchanged for individualized diagnosis and regular monitoring of bone age.

关 键 词：骨龄 一致性 儿童 籽骨 

分 类 号：R322.71[医药卫生—人体解剖和组织胚胎学] R814.41[医药卫生—基础医学]