超声定量评估骨龄对女童中枢性性早熟的诊断价值  

Quantitative assessment of bone age by ultrasound in diagnosis of central precocious puberty in girls

作　　者：程陈 刘岷[2] 孟繁博 张超[3] 骈林萍[2] CHENG Chen;LIU Min;MENG Fanbo;ZHANG Chao;PIAN Linping(Third Clinical College,Henan University of Chinese Medicine,Zhengzhou 450000,China;Department of Ultrasound,First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099,China;Department of Ultrasound,Tongji Hospital Affiliated of Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]河南中医药大学第三临床医学院,河南郑州450000 [2]河南中医药大学第一附属医院超声科,河南郑州450099 [3]华中科技大学同济医学院附属同济医院超声影像科,湖北武汉430030

出　　处：《中国中西医结合影像学杂志》2024年第5期603-606,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：河南省科技攻关项目(23210231121)。

摘　　要：目的:探讨超声定量评估骨龄对女童中枢性性早熟的诊断价值。方法:前瞻性纳入58例性早熟患儿,根据促性腺激素释放激素(GnRH)激发试验分为中枢性性早熟(CPP)组36例,外周性性早熟(PPP)组22例。2组均于1周内行X线骨龄和超声骨龄检查,对X线骨龄和超声骨龄行Kappa一致性分析,比较2组超声骨龄年龄差(BAD)和超声骨龄指数(BAI),利用ROC曲线对BAD和BAI诊断CPP的敏感度、特异度及AUC进行分析。结果:超声骨龄和X线骨龄诊断女童CPP的一致性较强(K=0.771);Bland-Altman图发现96.6%(56/58)的散点在上下95%CI参考线内均匀分布,差值均数为-0.18,两者具有较强的一致性。CPP组超声BAD及超声BAI均大于PPP组(t=5.539,4.943;均P<0.001)。超声BAD、BAI诊断CPP的AUC分别为0.841、0.820,敏感度分别为88.9%、72.2%,特异度分别为68.2%、77.3%。结论:超声骨龄与X线骨龄具有较好的一致性,使用超声定量评估骨龄对女童CPP具有一定的诊断价值。Objective:To explore the value of ultrasound quantitative assessment of bone age in the diagnosis of central precocious puberty(CPP)in girls.Methods:Fifty-eight girls with precocious puberty were prospectively included,according to GnRH stimulation test,they were divided into a central precocious puberty(CPP)group(36 cases)and a peripheral precocious puberty(PPP)group(22 cases).X-ray bone age and ultrasonic bone age were performed within 1 week for 58 cases.The consistency between X-ray bone age and ultrasound bone age was analyzed,and the ultrasound bone age difference(BAD)and ultrasound bone age index(BAI)were compared between the two groups.ROC curve was used to analyze the sensitivity,specificity and AUC of BAD and BAI in the diagnosis of CPP.Results:The consistency of ultrasound bone age and X-ray bone age in the diagnosis of CPP in girls was high(K=0.771).The Bland-Altman plot showed that 96.6%(56/58)scatter points were evenly distributed within the upper and lower 95%CI reference lines,and the mean difference was-0.18,indicating a strong consistency between the two methods.The ultrasound BAD and BAI of the CPP group were higher than those of the PPP group(t=5.539,4.943,both P<0.001).The AUCs of the BAD and BAI in the CPP group were 0.841 and 0.820,the sensitivities were 88.9%and 72.2%,and the specificities were 68.2%and 77.3%,respectively.Conclusions:Ultrasound bone age is in good agreement with X-ray bone age.Quantitative assessment of bone age by ultrasound has certain value in the diagnosis of CPP in girls.

关 键 词：超声检查 骨龄指数 中枢性性早熟 

分 类 号：R725.8[医药卫生—儿科] R445.1[医药卫生—临床医学]