Mentzel Hans-J, Vilser Claudia, Eulenstein Marcus, Schwartz Tseela, Vogt Susanna, Böttcher Joachim, Yaniv Irit, Tsoref Liat, Kauf Eberhard, Kaiser Werner A
Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University, Bachstrasse 18, 07740 Jena, Germany.
Pediatr Radiol. 2005 Apr;35(4):429-33. doi: 10.1007/s00247-004-1385-3. Epub 2005 Feb 24.
Determination of skeletal development in children is important. The most common method of evaluation uses the standards of Greulich and Pyle (G and P) to assess the left hand radiograph. Numerous assessments may be made during follow-up.
The aim of our study was to compare the accuracy of a new sonographic method with the standard radiographic method.
Seventy consecutive patients (age 6-17 years; 34 girls, 36 boys) underwent radiography of the left hand, followed by sonographic examination of the same hand using the BonAge system (Sunlight Medical Ltd., Israel). This system evaluates the relationship between the velocity of sound passing thorough the distal radial and ulna epiphysis and growth, using gender- and ethnicity-based algorithms. One experienced paediatric radiologist analysed the radiograph and assigned bone age scores based on the G and P atlas for the whole left hand and for the distal radius alone. The radiologist was blinded to the chronological age (CA), height of the patient and the BonAge result. Correlation between BonAge and G and P was undertaken.
In 65 patients, BonAge measurement could be performed successfully. In five patients, the scanning process was impossible using the ultrasound device. The r(2) (r is the Pearson correlation coefficient) of the BonAge ultrasound measurement and the G and P method was 0.82. The averaged accuracy (i.e. absolute difference in years between G and P reading and BonAge ultrasonic results) was calculated. Results were similar for boys and girls: 1.0+/-0.8 years for the whole left hand and 0.8+/-0.7 year for the distal radius. On average, the difference between BonAge and CA is the same as the difference between G and P and CA, i.e. 1.4 years.
The BonAge device demonstrates the ability of ultrasound to produce an accurate assessment of bone age. The results are highly correlated with skeletal age evaluated conventionally using the G and P method. Obvious advantages of the ultrasound device are objectivity, lack of ionizing radiation, and easy accessibility.
确定儿童骨骼发育情况很重要。最常用的评估方法是使用格鲁利希和派尔（G和P）标准来评估左手X线片。在随访期间可能会进行多次评估。
我们研究的目的是比较一种新的超声检查方法与标准X线检查方法的准确性。
连续70例患者（年龄6 - 17岁；34名女孩，36名男孩）接受了左手X线检查，随后使用BonAge系统（以色列阳光医疗有限公司）对同一只手进行超声检查。该系统使用基于性别和种族的算法，评估穿过桡骨和尺骨远端骨骺的声速与生长之间的关系。一位经验丰富的儿科放射科医生分析X线片，并根据G和P图谱为整个左手以及单独的桡骨远端指定骨龄分数。放射科医生对患者的实际年龄（CA）、身高和BonAge结果不知情。对BonAge与G和P之间进行相关性分析。
65例患者能够成功进行BonAge测量。5例患者无法使用超声设备完成扫描过程。BonAge超声测量与G和P方法的r²（r为皮尔逊相关系数）为0.82。计算了平均准确性（即G和P读数与BonAge超声结果之间的绝对年龄差异）。男孩和女孩的结果相似：整个左手为1.0±0.8岁，桡骨远端为0.8±0.7岁。平均而言，BonAge与CA之间的差异与G和P与CA之间的差异相同，即1.4岁。
BonAge设备证明了超声能够准确评估骨龄。结果与使用G和P方法传统评估的骨骼年龄高度相关。超声设备的明显优点是客观性、无电离辐射且易于操作。
