The Generation R Study Group, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands.
Br J Radiol. 2012 Feb;85(1010):114-20. doi: 10.1259/bjr/23858213. Epub 2011 May 17.
The aim of the study was to validate dual-energy X-ray absorptiometry (DXA) as a method to assess bone age in children.
Paired dual-energy X-ray absorptiometry (DXA) scans and X-rays of the left hand were performed in 95 children who attended the paediatric endocrinology outpatient clinic of University Hospital Rotterdam, the Netherlands. We compared bone age assessments by DXA scan with those performed by X-ray. Bone age assessment was performed by two blinded observers according to the reference method of Greulich and Pyle. Intra-observer and interobserver reproducibility were investigated using the intraclass correlation coefficient (ICC), and agreement was tested using Bland and Altman plots.
The intra-observer ICCs for both observers were 0.997 and 0.991 for X-ray and 0.993 and 0.987 for DXA assessments. The interobserver ICC was 0.993 and 0.991 for X-ray and DXA assessments, respectively. The mean difference between bone age assessed by X-ray and DXA was 0.11 years. The limits of agreement ranged from -0.82 to 1.05 years, which means that 95% of all differences between the methods were covered by this range.
Results of bone age assessment by DXA scan are similar to those obtained by X-ray. The DXA method seems to be an alternative for assessing bone age in a paediatric hospital-based population.
本研究旨在验证双能 X 射线吸收法（DXA）作为评估儿童骨龄的一种方法。
在荷兰鹿特丹大学医院儿科内分泌门诊就诊的 95 名儿童中，同时进行了双侧 DXA 扫描和左手 X 射线检查。我们比较了 DXA 扫描和 X 射线的骨龄评估结果。两名观察者根据 Greulich 和 Pyle 的参考方法进行了盲法骨龄评估。使用组内相关系数（ICC）评估了观察者内和观察者间的可重复性，并使用 Bland 和 Altman 图检验了一致性。
两名观察者的 X 射线和 DXA 评估的观察者内 ICC 分别为 0.997 和 0.991，0.993 和 0.987。X 射线和 DXA 评估的观察者间 ICC 分别为 0.993 和 0.991。X 射线和 DXA 评估的骨龄差值平均值为 0.11 岁。一致性界限范围为-0.82 至 1.05 岁，这意味着两种方法之间 95%的差异都在该范围内。
DXA 扫描评估骨龄的结果与 X 射线相似。DXA 方法似乎是评估儿科医院人群骨龄的一种替代方法。
