超声骺软骨厚度与骨龄的相关性分析

Correlation Analysis Between Ultrasonic Epiphysis Cartilage Thickness and Bone Age

目的结合长骨关节端的声像表现,初步探索采用超声定量评估骺软骨的发育情况,并分析其与骨龄的相关性。方法对2023年3—6月就读于济宁市某体校的青少年进行研究,记录年龄、身高等信息,于1周内行X线骨龄检查,并由1名内分泌科医师使用Greulich-Pyle图谱法评估骨龄。由2名超声医学科医师针对非优势侧手及腕部、膝关节共7个部位(包括第三掌骨头部背侧、尺骨茎突、桡骨茎突、股骨内上髁、股骨外上髁、胫骨背侧、胫骨内侧髁)进行超声检查,测量超声骺软骨厚度(ultrasonic epiphysis cartilage thickness,UECT),并分析其与骨龄的相关性。采用组内相关系数(intraclass correlation coefficient,ICC)评估UECT测量的信度与可重复性。结果共纳入141名青少年,其中男性80名,女性61名。中位年龄为13(12,14)岁,男性中位骨龄为15(13,17)岁,女性中位骨龄16(14,17)岁,男、女骨龄与年龄差值>1岁者分别占比60%、67%,男性身高显著高于女性。男、女7个部位UECT均随骨龄增长而减小,各部位UECT与骨龄均呈负相关。男性单部位UECT与骨龄均呈高度负相关(|r|≥0.80),女性则表现出中高度负相关(0.65≤|r|≤0.75)。男、女7个部位UECT总和与骨龄的负相关性均达到较高水平(|r|=0.93,|r|=0.80),单独选取手和腕部3个部位或膝关节4个部位时,女性UECT总和与骨龄呈高度负相关(|r|≥0.76),而男性则表现出非常高度负相关性(|r|≥0.90)。7个部位UECT的测量一致性均较好(ICC≥0.75)。结论超声可观察描述长骨关节端的生长发育变化,UECT与骨龄表现出中至高度负相关,具有用于骨成熟度定量评估的潜在价值。

Objective Preliminary exploration of using ultrasound to quantitatively evaluate the devel-opment of epiphyseal cartilage and analyze its correlation with bone age,based on the ultrasound findings of the long bone joint end.Methods A study was conducted on adolescents studying at a sports school in Jining from March to June 2023.Age,height and other information were recorded.Bone age assessment by X ray were performed within 1 week with an endocrinologist interpreted the bone age using the Greulich-Pyle at-las.Two sonographers scanned a total of 7 sites in the hand,wrist and knee joint of the non-dominant side(including the dorsal side of the third metacarpal head,the ulnar styloid process,the radial styloid process,the medial and the lateral femoral epicondyle,dorsal tibia,and medial tibial condyle).The ultra-sonic epiphyseal cartilage thickness(UECT)was measured and its correlation with bone age was analyzed.Intraclass correlation coefficient(ICC)was used to evaluate the reliability and repeatability of UECT meas-urement.Results A total of 141 adolescents were included,with 80 males and 61 females.The average age was 13(12-14)years old.The average bone age was 15(13-17)years in males and 16(14-17)years in females.The proportion of the males and females whose bone age was 1 year older than chronologi-cal age was 60%and 67%,respectively,and the height of the males was significantly higher than that of the females(P<0001).The UECT of 7 sites in the males and females decreased with the increase of bone age,and there was a significant negative correlation between UECT and bone age.In males,UECT was highly and negatively correlated with bone age(|r|≥080),while in females,it was moderately and negatively correlated(065≤|r|≤075).The correlation between the sum of UECT at seven sites and bone age reached high levels in both sexes(|r|=093,|r|=080).When 3 sites of hand and wrist or 4 sites of knee joint were selected separately,the UECT of the females was highly negatively correlated with bone age(|r|≥076),while that of the males showed a very high correlation(|r|≥090).The measurement consistency of UECT in all seven sites was good(ICC≥075).Conclusion Ultrasound can ob-serve and describe the developmental change of long bone,and UECT has potential value in quantitative evalua-tion of bone maturity.nology Development Fund Project(XZ202101YD0002C)