颈椎骨龄与牙龄推断上海地区儿童年龄的准确性比较

Comparison of the accuracy for evaluating cervical vertebral bone age and dental age of children in Shanghai

目的:评估并比较Willems牙龄推断法和上海地区特异性颈椎骨龄回归公式2种方法在推测上海地区儿童实足年龄上的适用性及准确性。方法:选取符合纳入标准的上海地区8~15岁儿童的全景片和头颅侧位片640张(男160名,女160名,全景片和头颅侧位片各320张),分别运用Willems法和颈椎骨龄回归公式评估得到牙龄和颈椎骨龄。采用SPSS 25.0软件包中的配对t检验或Wilcoxon符号秩检验,评估实足年龄与推断年龄之间的差异;通过比较2种方法的标准差、平均绝对误差、可接受误差内的正确判断率,对2种方法的准确性进行评价。结果:相比实足年龄,男性牙龄平均低估(0.75±1.03)岁,女性平均低估(1.05±1.18)岁;男性颈椎骨龄平均低估(0.78±1.40)岁,女性平均低估(0.53±1.31)岁。Willems牙龄推断法的总平均绝对误差为1.15岁,上海地区颈椎骨龄回归公式的总平均绝对误差为1.20岁。临床可接受误差在±0.5岁内的正确判断率Willems法和颈椎骨龄回归公式分别为26.25%和27.19%。结论:相比上海地区特异性颈椎骨龄回归公式,Willems法在推断上海地区8~15岁儿童的实足年龄上的适用性和准确性更高。但因推断年龄与实足年龄仍存在差异,2种方法仍需改进。

PURPOSE:To compare the applicability and validity of dental age(DA)estimated by Willems method and cervical vertebral bone age(CVBA)evaluated by regression formula in estimating the chronological age of children in Shanghai.METHODS:Panoramic radiographs and lateral cephalograms were retrospectively collected from 320 subjects(160 males,160 females),totaling 640 images.Discrepancies between chronological and estimated ages were statistically calculated by paired samples t test or Wilcoxon signed rank test using SPSS 25.0 software package.The accuracy of the two methods was comprehensively evaluated by comparing their standard deviation,mean absolute error(MAE)and the correct rate of acceptable range of estimated age error.RESULTS:The mean DA underestimated CA by 0.75±1.03 years for males and by 1.05±1.18 years for females;whereas the mean CVBA underestimated CA by 0.78±1.40 years for males and 0.53±1.31 years for females.MAE of Willems method was 1.15 years and the MAE of regression formula of CVBA was 1.20 years.The correct rate of clinically acceptable error of 0.5 years was 26.25%for Willems method and 27.19%for regression formula of CVBA.CONCLUSIONS:Willems method is more accurate than regression formula in indicating cervical vertebral skeletal age of adolescents in Shanghai children.Because of significant differences between CA and estimated ages,further modifications are urged to improve the accuracy of these two methods.