MRI探索儿童斜坡开始黄髓化的年龄界值

Exploring the cut-off age value of marrow transformation in children's clivus by MRI

目的通过分析儿童正常斜坡的MRI特点,探索儿童斜坡开始黄髓化的年龄界值,以利于更好地识别骨髓病变。材料与方法选取2022年4月至2023年10月在本院放射科行颅脑MRI检查的儿童作为研究对象,通过分析2141例儿童正常斜坡信号特点与年龄分布的关系,探讨儿童斜坡开始黄髓化的年龄界限。在T1WI序列正中矢状面观察斜坡的信号特点,分析未黄髓化及黄髓化年龄分布特点,计算Youden指数及绘制年龄预测斜坡黄髓化的受试者工作特征(receiver-operating chatacteristic,ROC)曲线,探索儿童斜坡开始黄髓化的年龄界值。结果2141例儿童中,男孩1339例,女孩802例。1339例男孩中,未黄髓化者521例(1个月~36个月),黄髓化者818例(4个月~180个月);802例女孩中,未黄髓化者326例(1个月~35个月),黄髓化者476例(5个月~201个月)。男孩年龄为13.5个月时,Youden指数为0.814,ROC曲线下面积(area under the curve,AUC)为0.976,95%置信区间(confidence interval,CI):0.969~0.982;女孩年龄为11.5个月时,Youden指数0.836,AUC为0.980,95%CI:0.973~0.987。结论年龄>13.5个月可作为男孩斜坡开始黄髓化的年龄界值;年龄>11.5个月可作为女孩斜坡开始黄髓化的年龄界值;男孩开始黄髓化的年龄晚于女孩。

Objective:To analyze the characteristics of MRI of normal slopes in children,and to explore the cut-off age value for the onset of marrow transformation of the clivus in children,so as to better identify myelopathy.Materials and Methods:The children who underwent cerebral magnetic resonance examination in the Department of Radiology of our hospital from April 2022 to October 2023 were selected as the research objects.By analyzing the relationship between the characteristics of normal clivus's signal and age distribution in 2141 children,the age standard of the beginning of marrow transformation in children's clivus was explored.The signal characteristics of the clivus were observed on the median sagittal plane of the craniocerebral MRI T1WI sequence,and the age distribution characteristics of non-transformation and transformation were analyzed.Youden index was calculated and the receiver-operating chatacteristic(ROC)curve was drawn to explore the cut-off age value of the beginning of marrow transformation in children's clivus.Results:Among the 2141 children,1339 were boys and 802 were girls.Among 1339 boys,521 boys(1 month-36 months)had clivus with non-transformated marrow and 818 boys(4 months-180 monts)had clivus with transformated marrow.Among the 802 girls,326 girls(1 month-35 months)had clivus with non-transformated marrow and 476 girls(5 months-201 months)had clivus with transformated marrow.When the boy was 13.5 months old,the Youden index was the highest(0.814),and the area under ROC curve was the largest[0.976(95%CI:0.969-0.982)].When the girl was 11.5 months old,the Youden index was 0.836 and the area under the ROC curve was 0.980(95%CI:0.973-0.987).Conclusions:The age of boys>13.5 months can be regarded as the cut-off age value of marrow transformation of the clivus.The age of girls was>11.5 months,which could be used as the cut-off age value of marrow transformation of the clivus.Marrow transformation begins later in boys than in girls.