磁共振成像在健康男性儿童骨骼骨龄评估中的价值。
Value of Magnetic Resonance Imaging for Skeletal Bone Age Assessment in Healthy Male Children.
机构信息
Department of Diagnostic and Interventional Radiology, Goethe-University Hospital Frankfurt, Frankfurt am Main, Germany.
Faculty of Medicine and University Hospital Cologne, Cologne Germany.
出版信息
Top Magn Reson Imaging. 2023 Oct 1;32(5):50-55. doi: 10.1097/RMR.0000000000000306. Epub 2023 Aug 24.
BACKGROUND
Skeletal bone age assessment for medical reasons is usually performed by conventional x-ray with use of ionizing radiation. Few pilot studies have shown the possible use of magnetic resonance imaging (MRI).
PURPOSE
To comprehensively evaluate feasibility and value of MRI for skeletal bone age (SBA) assessment in healthy male children.
MATERIALS AND METHODS
In this prospective cross-sectional study, 63 male soccer athletes with mean age of 12.35 ± 1.1 years were examined. All participants underwent 3.0 Tesla MRI with coronal T1-weighted turbo spin echo (TSE), coronal proton density (PD)-weighted turbo spin echo (TSE), and T1-weighted three-dimensional (3D) volume interpolated breath-hold examination (VIBE) sequence. Subsequently, SBA was assessed by 3 independent blinded radiologists with different levels of experience using the common Greulich-Pyle (GP) atlas and the Tanner-Whitehouse (TW2) method.
RESULTS
In a mean total acquisition time of 5:04 ± 0:47 min, MR image quality was sufficient in all cases. MRI appraisal was significantly faster ( P < 0.0001) by GP with mean duration of 1:22 ± 0:08 min vs. 7:39 ± 0:28 min by TW. SBA assessment by GP resulted in mean age of 12.8 ± 1.2 years, by TW 13.0 ± 1.4 years. Interrater reliabilities were excellent for both GP (ICC = 0.912 (95% confidence interval [CI] = 0.868-0.944) and TW (ICC = 0.988 (95% CI = 0.980-0.992) and showed statistical significance ( P < 0.001). Subdivided, for GP, ICCs were 0.822 (95% CI = 0.680-0.907) and 0.843 (95% CI = 0.713-0.919) in Under 12 and Under 14 group. For TW, ICCs were 0.978 (95% CI = 0.958-0.989) in Under 12 and 0.979 (95% CI = 0.961-0.989) in Under 14 group.
CONCLUSION
MRI is a clinically feasible, rapidly evaluable method to assess skeletal bone age of healthy male children. Using the Greulich-Pyle (GP) atlas or the Tanner-Whitehouse (TW2) method, reliable results are obtained independent of the radiologist's experience level.
背景
出于医疗原因进行骨骼骨龄评估通常通过常规 X 射线和电离辐射来完成。少数试点研究表明磁共振成像（MRI）可能具有应用潜力。
目的
全面评估 MRI 对健康男性儿童骨骼骨龄（SBA）评估的可行性和价值。
材料和方法
在这项前瞻性的横断面研究中，共纳入 63 名平均年龄为 12.35±1.1 岁的男性足球运动员。所有参与者均接受 3.0T MRI 检查，包括冠状位 T1 加权涡轮自旋回波（TSE）、冠状位质子密度（PD）加权涡轮自旋回波（TSE）和 T1 加权三维（3D）容积内插屏气检查（VIBE）序列。随后，由 3 名具有不同经验水平的独立盲法放射科医生使用常见的 Greulich-Pyle（GP）图谱和 Tanner-Whitehouse（TW2）方法评估 SBA。
结果
在平均总采集时间为 5:04±0:47 分钟内，所有病例的 MRI 图像质量均充足。使用 GP 进行评估明显更快（P<0.0001），平均用时 1:22±0:08 分钟，而使用 TW 则为 7:39±0:28 分钟。使用 GP 评估的骨骼骨龄平均为 12.8±1.2 岁，使用 TW 则为 13.0±1.4 岁。GP（ICC=0.912（95%置信区间[CI]为 0.868-0.944）和 TW（ICC=0.988（95% CI 为 0.980-0.992）的评估者间可信度均很高，且具有统计学意义（P<0.001）。细分来看，GP 的 ICC 值在 12 岁以下组和 14 岁以下组分别为 0.822（95% CI 为 0.680-0.907）和 0.843（95% CI 为 0.713-0.919），TW 的 ICC 值在 12 岁以下组和 14 岁以下组分别为 0.978（95% CI 为 0.958-0.989）和 0.979（95% CI 为 0.961-0.989）。
结论
MRI 是一种具有临床可行性、快速评估方法，可用于评估健康男性儿童的骨骼骨龄。使用 Greulich-Pyle（GP）图谱或 Tanner-Whitehouse（TW2）方法，无论放射科医生的经验水平如何，均可获得可靠的结果。
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