Department of Pediatrics, University of Chieti, Chieti, Italy.
Ultraschall Med. 2011 Dec;32 Suppl 2:E129-33. doi: 10.1055/s-0031-1281972. Epub 2011 Dec 22.
Thyroidal hormones are important for bone development, and ultrasonographic (US) evaluation of the distal femoral epiphysis (DFE) has recently been suggested as a new method for the assessment of skeletal maturity in infants. A delayed bone maturation, expressed by a smaller or absent DFE nucleus (in terms of DFE surface area, sum of the epiphyseal diameters, or DFE height and acetabular size), has been largely demonstrated in diagnosed hypothyroid infants, while no data analyze the role and meaning of the DFE dimensions (in terms of volume) in newborn before knowledge of the congenital neonatal screening results. The aims of the present study were to ultrasonographically evaluate the volume of DFE in newborns, and to determine whether it has any predictive role for the thyroidal status at birth.
238 newborns (M/F: 121 /117) were evaluated. The gestational age, body weight and length at birth were registered. Neonatal screening for congenital hypothyroidism (CH), based on TSH levels on blood spot, was performed in all on the 3 rd day of life. The DFE volume was ultrasonographically evaluated, taking into account the three diameters of the DFE nucleus, within 48 hours of birth.
No newborn was found to have CH on neonatal screening. The DFE volume ranged between 0.00 cm and 0.61 cm (mean 0.14 ± 0.10 cm, median 0.13 cm). The DFE volume did not differ between males and females, while it was significantly greater in at term babies than in preterm babies. No differences in TSH values at screening were noted among the groups. The DFE volume was significantly related to gestational age, birth weight and length. A significant relationship was found between the DFE volume and TSH concentrations at screening.
US evaluation of DFE volume provides a simple method for assessing bone maturity at birth, which is related to gestational age, body weight and length at birth. Nonetheless, it has any predictive role for thyroidal status at birth, being not related to TSH levels on neonatal screening for CH.
甲状腺激素对骨骼发育很重要，最近有研究提出，通过超声（US）评估远端股骨骨骺（DFE）可以作为一种新方法来评估婴儿的骨骼成熟度。在确诊的甲状腺功能减退症婴儿中，已经广泛证实存在骨成熟延迟，表现为 DFE 核较小或缺失（以 DFE 表面积、骺直径总和、DFE 高度和髋臼大小表示），而在新生儿筛查结果未知的情况下，尚未有研究分析 DFE （以体积表示）维度在新生儿中的作用和意义。本研究的目的是通过超声评估新生儿 DFE 的体积，并确定其是否对出生时的甲状腺状态有预测作用。
共评估了 238 名新生儿（男/女：121/117）。记录了胎龄、出生体重和身长。所有新生儿均在出生后第 3 天行先天性甲状腺功能减退症（CH）的新生儿筛查，基于血斑 TSH 水平。在出生后 48 小时内，通过超声评估 DFE 核的三个直径，以评估 DFE 体积。
新生儿筛查未发现 CH 患儿。DFE 体积范围在 0.00cm 到 0.61cm 之间（平均值 0.14±0.10cm，中位数 0.13cm）。男性和女性之间的 DFE 体积没有差异，而足月婴儿的 DFE 体积明显大于早产儿。筛查时各组 TSH 值无差异。DFE 体积与胎龄、出生体重和身长显著相关。DFE 体积与筛查时 TSH 浓度之间存在显著关系。
DFE 体积的 US 评估为评估出生时的骨骼成熟度提供了一种简单的方法，其与胎龄、出生体重和身长有关。然而，它对出生时的甲状腺状态没有预测作用，与 CH 的新生儿筛查 TSH 水平无关。
