青少年骨发育X线分级方法

Staging Methods of Skeletal Growth by X-ray in Teenagers

目的利用青少年骨关节X线影像变化规律制定青少年骨发育X线分级标准。方法参照国内外权威学者关于不同部位关节骨骼发育分级的研究成果,以骺软骨发育组织学分层(区)为理论支撑、以骨发育X线影像特征为基础的分级原理,横向和纵向观察我国河南、海南、浙江三个省份300名11～20周岁男、女性青少年双侧锁骨胸骨端及左侧肩、肘、腕、髋、膝、踝关节骨发育X线影像特征,选取与年龄变化关系密切的24项骨骼发育指标。结果根据不同部位关节骨骺生长变化规律,将24项骨骼发育指标分为2级至8级不等。研究显示,各单一关节组成诸骨发育指标的分级基本相同或接近,单一关节内不同的骨骺发育变化具有同步性。结论本分级标准涉及骨骼发育指标广、适用年龄范围宽、可操作性强,为我国法医学活体骨骼年龄推断建立了良好的基础平台。

Objective To establish staging criteria for teenager′s skeletal growth by examining osteoarticular X-rays. Methods Review publications on skeletal growth staging systems by domestic and overseas authorities. Abided by the staging principles on theory of cartilage epiphyseal growth and X-ray images of skeletal growth, X-ray imaging characteristics were studied through three hundred male and female teenagers epiphyseal growth of both sternal ends of clavicle and the left side of shoulder, elbow, carpal, hip, knee and ankle joints transversally and longitudinally. The subjects were from 11 to 20 years old, selected from Henan, Hainan and Zhejiang province in China. Twenty-four skeletal growth indexes were selected closely related to age. Results Based on regular changing characteristics of epiphyseal growth at different joints, 24 skeletal development indexes were divided into 2 to 8 stages. The stage number of different indexes of the single joint were similar. It was shown that the time of different epiphyseal growth in identical joints had isochromism. Conclusion These staging criteria have merits of extensive skeletal growth indexes, and are applicable to wide age range with a strong maneuverability. It provides a favorable fundamental platform for forensic evaluating skeletal age in living subjects in China.