Department of Radiological Sciences, University of Najran, Saudi Arabia.
Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, UK.
Clin Radiol. 2020 Feb;75(2):156.e1-156.e9. doi: 10.1016/j.crad.2019.08.029. Epub 2019 Nov 6.
To assess the applicability of the Greulich & Pyle (G&P) and Tanner & Whitehouse (TW3) methods to children from Saudi Arabia using both subjective (manual) rating and BoneXpert software.
Bone age (BA) was assessed using the G&P and TW3 methods, firstly by independent manual rating of two observers, followed by a single observer using the BoneXpert software program. In total, 420 hand trauma radiographs for Saudi Arabians (220 males, 329 left, age range 1-18 years) performed in the period January 2012 to September 2016 were assessed. Paired sample t test was used to compare the difference between mean BA and mean chronological age (CA) and to compare the difference between manual and BoneXpert ratings. Statistical analysis was undertaken using SPSS v.25.
A statistically significant difference was found between BA and CA in males when using the G&P (mean difference -0.36±1 years, p<0.01) and TW3 (mean difference -0.22±0.9 years, p=0.03) methods, but not in females for either G&P (mean difference 0.13±1.2 years) or TW3 (mean difference 0.08±1.1 years). In males, BoneXpert results conformed to the manual ratings for TW3, but not for G&P, for which the mean difference between manual and BoneXpert ratings was -0.27±0.5 years (p<0.01).
The present results indicate that manual and BoneXpert-derived G&P and TW3 bone age assessment can be applied with no modification to Saudi Arabian females; however, only TW3 BoneXpert-derived BA can be applied without caution to Saudi Arabian males.
使用主观（手动）评分和 BoneXpert 软件评估沙特阿拉伯儿童的 Greulich & Pyle（G&P）和 Tanner & Whitehouse（TW3）方法的适用性。
使用 G&P 和 TW3 方法评估骨龄（BA），首先由两名观察者进行独立的手动评分，然后由一名观察者使用 BoneXpert 软件程序进行评分。总共评估了 2012 年 1 月至 2016 年 9 月期间在沙特阿拉伯进行的 420 例手部创伤 X 光片（220 名男性，329 名左手，年龄范围为 1-18 岁）。采用配对样本 t 检验比较 BA 与实际年龄（CA）的平均值之间的差异，并比较手动评分和 BoneXpert 评分之间的差异。使用 SPSS v.25 进行统计分析。
使用 G&P（平均差值-0.36±1 岁，p<0.01）和 TW3（平均差值-0.22±0.9 岁，p=0.03）方法时，男性的 BA 与 CA 之间存在统计学显著差异，但女性的 G&P（平均差值 0.13±1.2 岁）或 TW3（平均差值 0.08±1.1 岁）均无差异。在男性中，BoneXpert 结果与 TW3 的手动评分相符，但与 G&P 不符，手动评分和 BoneXpert 评分之间的平均差值为-0.27±0.5 岁（p<0.01）。
本研究结果表明，无需修改即可将手动和 BoneXpert 衍生的 G&P 和 TW3 骨龄评估应用于沙特阿拉伯女性；然而，只有 TW3 BoneXpert 衍生的 BA 可以在没有谨慎的情况下应用于沙特阿拉伯男性。
