骨龄测评桡骨接近完全融合与融合遗迹的影像学鉴别探讨

lconographical identification of the time for complete fusion of radius and fusion trace

目的探讨桡骨接近完全融合时与融合遗迹的影像学鉴别方法。方法 18岁以下研究组31例,每1例均有同日同次2张左手腕部正位片和分别倾斜30°和45°2张斜位 X 线片,共124次曝光片。18.0岁以上对照组,每例有1张手腕部正位片,其中6例另有1张手腕部斜位片,共17次曝光片。合计42例141次曝光片。对比分析两组间桡骨远端缺口形态、与桡骨关系、低密度骺线是否存在及尺骨融合情况。结果研究组:桡骨未完全融合者其缺口均深入桡骨轮廓之内,尺骨茎突基底部均存在低密度骺线及缺口,多位置和多角度观察发现低密度骺线者8例。对照组桡骨远端缺口位于桡骨轮廓之外并能未深入桡骨轮廓之内,且缺口内缘为正常骨皮质封闭。桡骨致密融合线未见显示7例(64%),尺骨已完全融合。结论与融合遗迹不同,在多位置和多角度片中如能发现桡骨低密度骺线存在、明确缺口位于桡骨轮廓之内和尺骨茎突基底部尚未完全融合,即可确定桡骨尚未完全融合。

Objective To investigate the method for iconographical identification of complete fusion of radius and fusion trace, Methods 31 cases under age 18 were photographed in the left wrists twice at anteroposterior position and the 30° ＆ 45°vertical position by X ray in the same day, with 124 pictures exposed totally. For each case of the control group over 18, an anteroposterior picture was obtained and pictures at an angle with 6 cases, totally 17 pictures expose.d, All the pictures were 141 exposed totally from 42 cases. A comparison then was made as for the morpha of the far-end of radius, the relationship with radius, the presence of low-density epiphyseal line and the fusion status of ulna between two groups. Results Subject Group： the gap was extended into the frame of the radius and low density-epiphyseal line and gap existed in the base of processus styloldeus for patients with incomplete fusion. 8 cases of low-epiphyseal lines were found from multi-angle and multi-location. In the contrast group, the far-end gap was outside of the frame of radius and didn＇t extend into the frame of radius and the internal edge of the gap was normally closed by the bone cortex. Dense fusion line of the radius was not found in 7 cases （64%） and the ulna was completely fused, Conclusion Different from that of fusion trace, low-density epiphyseal line of the radius was not found from multi-angle and multi-location. It was identified that the gap was within the frame of radius and the base of the ulna proeessus styloldeus was not completely fused. Non-thoroughly fusion in radius could be confirmed.