面积骨化率——常规超声定量评估青少年骨龄的新参数

杨亚梅; 张莉; 张怡璇; 赵泽庆; 谷怡琳; 陈适; 潘慧; 王凤丹; 杨筱; 李建初

doi:10.12290/xhyxzz.2024-0202

面积骨化率——常规超声定量评估青少年骨龄的新参数

Area Ossification Ratio: A New Parameter for Quantitative Assessment of Adolescent Bone Age by Conventional Ultrasonography

摘要

摘要:
目的探索常规超声定量评估青少年骨龄的新参数——面积骨化率(area ossification ratio，AOR)，并评价AOR与放射学骨龄之间的相关性。
方法选取2023年6月山东省某中学的健康青少年为研究对象，采集其左侧尺骨茎突冠状面、桡骨茎突冠状面、股骨外上髁冠状面、胫骨内侧髁冠状面及胫骨后正中矢状面5个部位的超声图像，勾画出二维超声图像中的骨化中心及骨骺面积，计算AOR，并与Greulich-Pyle(GP)图谱法测量的放射学骨龄进行比较；采用组内相关系数(intraclass correlation coefficient，ICC)及Bland-Altman法评估观察者间及观察者内一致性。
结果共纳入179名(男: 109名，女: 70名)健康青少年；男、女青少年5个部位的AOR与放射学骨龄之间均呈显著或高度相关(r=0.60~0.91)；男、女青少年5个部位的AOR总和与放射学骨龄呈高度相关(男：r=0.95，女：r=0.87)。不同医师及同一医师测量的AOR值具有较高可重复性(观察者间一致性：ICC=0.926，P＜0.001；观察者内一致性：ICC=0.954，P＜0.001)。
结论青少年的AOR总和与放射学骨龄呈高度相关，其测量方法具有较高的可重复性，AOR是常规超声定量评估青少年骨龄的可靠参数。

Abstract:
Objective To research on area ossification ratio (AOR), a novel parameter for quantitatively assessing adolescent bone age by conventional ultrasonography, and evaluate the correlation between AOR and radiographic bone age.
Methods The study selected healthy adolescents from a middle school in Shandong Province in June 2023. Ultrasonic images were collected from five anatomical sites (the styloid process of the ulna, the styloid process of the radius, the lateral epicondyle of the femur, the medial condyle of the tibia, and the posterior median sagittal plane of the tibia). The second ossification center and epiphyseal area on these 2D ultrasound images were delineated to calculate AOR. This ratio was then compared with radiographic bone age measured by Greulich-Pyle (GP) atlas. Inter- and intra-observer consistency was evaluated using intraclass correlation coefficient (ICC) and the Bland-Altman method.
Results A total of 179 healthy adolescents (109 males and 70 females) were included. For both genders, AOR of each site exhibited a significant to high correlation with radiological bone age (r=0.60~0.91). The sum of the AORs of the five sites showed a high correlation with radiological bone age (males: r=0.95, females: r=0.87). Measurements of AOR by different doctors and the same doctor at different times demonstrated high repeatability (inter-observer: ICC=0.926, P < 0.001, intra-observer: ICC=0.954, P < 0.001).
Conclusions The sum of AORs in adolescents is highly correlated with radiographic bone age, and the measurement method shows high repeatability. The AOR is a reliable parameter for the ultrasonic quantitative assessment of bone age in adolescents.

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