Khan Khalid M, Miller Bradley S, Hoggard Eric, Somani Arif, Sarafoglou Kyriakie
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
J Pediatr. 2009 Feb;154(2):243-7. doi: 10.1016/j.jpeds.2008.08.018. Epub 2008 Sep 27.
To assess the validity of bone age assessment by ultrasonography (US).
Wrist US was performed on children (n = 100) undergoing radiographic bone age and compared with bone age estimation by a radiologist in the clinic and by endocrinologists under blinded conditions with Greulich and Pyle (GP) and Tanner and Whitehouse (TW3) methods.
The strongest correlation (r(2)) was seen in the radiographic bone age assessment between the 2 endocrinologists using the GP method (96.7%). The poorest correlation was seen when comparing radiographic methods to US of either wrist (74.6% to 82.6%). When bone age correlations were divided into normal, delayed or advanced, the highest correlation between the radiographic and US methods was found in the normal bone age group (80.9% to 86.1%) with weaker correlations for the delayed bone age group (77.1% to 86.9%) and the advanced bone age group (62.2% to 81.1%). US tended to overread delayed bone age and underread advanced bone age. US had poor positive and negative predictive value for identification of a normal or delayed bone age. The negative predictive value of US was 91% for an advanced bone age.
On the basis of our data, US assessment should not yet be considered a valid replacement for radiographic bone age determination.
评估超声（US）骨龄评估的有效性。
对100名接受X线骨龄检查的儿童进行腕部超声检查，并与临床放射科医生以及内分泌科医生在盲法条件下采用格鲁利希和派尔（GP）法及坦纳和怀特豪斯（TW3）法进行的骨龄估计相比较。
在使用GP法的两名内分泌科医生之间，X线骨龄评估的相关性最强（r²）（96.7%）。将X线方法与任一腕部超声检查相比较时，相关性最差（74.6%至82.6%）。当骨龄相关性分为正常、延迟或提前时，X线和超声方法之间的最高相关性出现在正常骨龄组（80.9%至86.1%），延迟骨龄组（77.1%至86.9%）和提前骨龄组（62.2%至81.1%）的相关性较弱。超声往往高估延迟骨龄并低估提前骨龄。超声在识别正常或延迟骨龄方面的阳性和阴性预测价值较差。超声对提前骨龄的阴性预测价值为91%。
根据我们的数据，超声评估目前不应被视为X线骨龄测定的有效替代方法。
