基于便携式骨龄检测仪对杭嘉湖地区儿童及青少年骨龄调查研究

Survey on the bone age of children and adolescents in Hang-Jiu-Hu region with portable bone age detector

目的基于便携式骨龄检测仪对杭嘉湖地区儿童及青少年骨龄情况进行调查研究,为该地区的骨龄评估方法提供参考。方法回顾性收集1054名杭嘉湖地区3~18岁儿童及青少年的X线骨龄图像,并对骨龄图像进行骨龄判读,分析男性、女性的骨龄发育与生活年龄的差异及Greulich-Pyle图谱法(GP)、Tanner Whitehouse Ⅲ(TW3)计分法R系列(TW3-R)和C系列(TW3-C)两种以及《中国人手腕骨发育标准——中华05》法(中华05法)中的中华05-R系列、中华05-C系列5种骨龄评估方法的变化趋势,并对身高、BMI百分位数进行亚组分析。结果男性组≥3~<9岁年龄段及≥13~<18岁年龄段5种评估方法的骨龄结果差异均有统计学意义(均P<0.05)。≥9~<13岁年龄段间不同评估方法结果差异均无统计学意义(均P>0.05)。女性组从≥3~<5岁到≥13~<15岁的年龄段5种测评方法的结果差异均有统计学意义(均P<0.05)。5种骨龄评估方法所测骨龄与生活年龄的差值随年龄变化的趋势并无明显的性别差异。TW3-R系列在所有年龄段骨龄测量结果均比较接近实际生活年龄,中华05-C系列和TW3-C系列在中间层年龄段的骨龄测量结果更为准确。结论基于便携式骨龄检测仪的5种骨龄评价方法具有一定的准确度,但无法精确反映杭嘉湖地区儿童及青少年的骨骼发育实际情况,放射科医师需结合多种评估方式综合分析。

Objective To survey the bone age(BA)of children and adolescents in Hang-Jia-Hu region with portable bone age detector.Methods The the portable bone age detector was applied for bone age measurement among 1054 children and adolescents aged 3-18 in Hang-Jia-Hu region.The embedded deep learning algorithm was used to interpret the BA.The difference between BA and chronological age(CA)of males and females,and the change trend of five bone age assessment(BAA)methods[Greulich-Pyle,Tanner Whitehouse ⅢR series(radius,ulna,and short finger bones,TW3-R)],C series(Carpals,TW3-C)and China 05 series(China 05-R and China 05-C series)were analyzed.Moreover,the height and BMI percentiles were analyzed by subgroup.Results There were significant differences in the results among the 5 BAA methods in males of the≥3-<9 and≥13-<18 age groups,and in females of≥3-<5 and≥13-<15 age groups(all P<0.05).There was no significant difference in the results of≥9-<13 age group among 5 BAA methods(all P>0.05).There was no significant difference between the BA and CA in different sex groups by the 5 BAA methods.The BAA results of TW3-R series were relatively close to CA at all age groups,and the BAA results of China 05-C series and TW3-C series were more accurate in the≥9-<13 age group.BA measured by the China 05-C series,TW3-C series and GP series methods of 4 male samples and 5 BAA methods of 2 female samples with height<P3 were all less than CA.BA measured by 5 BAA methods of 7 male samples with BMI<P3 were all less than CA,while BA of 10 female samples were higher than CA.Conclusion There is a certain degree of accuracy of bone age measured by the portable bone age detector with 5 BAA analysis methods,but they cannot accurately reflect the actual bone development of children and adolescents.Radiologists need to combine several BAA methods for comprehensive analysis.