Department for Diagnostic and Interventional Radiology, University Ulm Medical Centre, Ulm, Germany.
Division of Pediatric Endocrinology and Diabetes, University Ulm Medical Centre, Ulm, Germany.
Rofo. 2021 Jun;193(6):692-700. doi: 10.1055/a-1313-7664. Epub 2020 Dec 17.
The determination of bone age is a method for analyzing biological age and structural maturity. Bone age estimation is predominantly used in the context of medical issues, for example in endocrine diseases or growth disturbance. As a rule, conventional X-ray images of the left wrist and hand are used for this purpose. The aim of the present study is to investigate the extent to which MRI can be used as a radiation-free alternative for bone age assessment.
In 50 patients, 19 females and 31 males, in addition to conventional left wrist and hand radiographs, MRI was performed with T1-VIBE (n = 50) and T1-TSE (n = 34). The average age was 11.87 years (5.08 to 17.50 years). Bone age assessment was performed by two experienced investigators blinded for chronological age according to the most widely used standard of Greulich and Pyle. This method relies on a subjective comparison of hand radiographs with gender-specific reference images from Caucasian children and adolescents. In addition to interobserver and intraobserver variability, the correlation between conventional radiographs and MRI was determined using the Pearson correlation coefficient.
Between the bone age determined from the MRI data and the results of the conventional X-ray images, a very good correlation was found for both T1-VIBE with r = 0.986 and T1-TSE with r = 0.982. Gender differences did not arise. The match for the interobserver variability was very good: r = 0.985 (CR), 0.966 (T1-VIBE) and 0.971 (T1-TSE) as well as the match for the intraobserver variability for investigator A (CR = 0.994, T1-VIBE = 0.995, T1-TSE = 0.998) and for investigator B (CR = 0.994, T1-VIBE = 0.993, T1-TSE = 0.994).
The present study shows that MRI of the left wrist and hand can be used as a possible radiation-free alternative to conventional X-ray imaging for bone age estimation in the context of medical issues.
· MRI and X-ray show a very good correlation for bone age determination in medical issues.. · With short examination times, T1 VIBE shows slight advantages over T1 TSE.. · Both investigators show high intra- and interobserver variability..
· Diete V, Wabitsch M, Denzer C et al. Applicability of Magnetic Resonance Imaging for Bone Age Estimation in the Context of Medical Issues. Fortschr Röntgenstr 2021; 193: 692 - 700.
骨龄测定是分析生物年龄和结构成熟度的一种方法。骨龄评估主要用于医学问题,例如内分泌疾病或生长障碍。通常,使用左手腕和手的常规 X 射线图像进行此目的。本研究的目的是调查 MRI 作为无辐射替代骨龄评估的程度。
在 50 名患者中,19 名女性和 31 名男性,除了常规的左手腕和手部射线照相术外,还使用 T1-VIBE(n=50)和 T1-TSE(n=34)进行了 MRI。平均年龄为 11.87 岁(5.08 至 17.50 岁)。根据最广泛使用的 Greulich 和 Pyle 标准,由两名具有经验的研究人员根据生物年龄评估进行盲法评估。该方法依赖于对手腕射线照相与白种人儿童和青少年特定性别参考图像的主观比较。除了观察者间和观察者内变异性外,还使用 Pearson 相关系数确定常规射线照相术和 MRI 之间的相关性。
从 MRI 数据确定的骨龄与常规 X 射线图像的结果之间,T1-VIBE 的 r=0.986 和 T1-TSE 的 r=0.982 之间存在非常好的相关性。没有出现性别差异。观察者间变异性的匹配非常好:r=0.985(CR),0.966(T1-VIBE)和 0.971(T1-TSE)以及研究员 A 的观察者内变异性的匹配(CR=0.994,T1-VIBE=0.995,T1-TSE=0.998)和研究员 B(CR=0.994,T1-VIBE=0.993,T1-TSE=0.994)。
本研究表明,MRI 左手腕和手可作为医学问题中常规 X 射线成像骨龄评估的无辐射替代方法。
·MRI 和 X 射线在医学问题中确定骨龄时显示出非常好的相关性。·使用较短的检查时间,T1 VIBE 显示出比 T1 TSE 略高的优势。·两位研究人员均显示出较高的观察者内和观察者间变异性。