Zhang Yixuan, Yang Xiao, Zhang Li, Zhao Zeqing, Yang Yamei
Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Front Pediatr. 2025 Aug 21;13:1615923. doi: 10.3389/fped.2025.1615923. eCollection 2025.
Bone age assessment is a critical tool for evaluating skeletal maturity in children and adolescents, with implications for growth monitoring and clinical decision-making. While traditional radiographic methods such as the Greulich-Pyle and Tanner-Whitehouse systems remain the gold standard, concerns over ionizing radiation exposure have spurred interest in ultrasound-based alternatives. This mini-review synthesizes current evidence on ultrasound bone age assessment, highlighting its advantages as a radiation-free, non-invasive modality with strong correlations to radiographic standards. Key advancements include standardized scoring systems, ossification ratios (e.g., radius/ulna/femur), and acoustic measures (e.g., speed of sound), which enhance reliability and reduce inter-operator variability. However, challenges persist, including protocol standardization, population-specific variability, and operator dependency, particularly in advanced pubertal stages. Future directions emphasize the development of large-scale, longitudinal and multi-ethnic reference databases, consensus guidelines, and AI integration to improve precision. Ultrasound bone age assessment shows promise as a viable clinical tool, but further refinements are needed to address its limitations and ensure equitable applicability across diverse populations.
骨龄评估是评估儿童和青少年骨骼成熟度的关键工具，对生长监测和临床决策具有重要意义。虽然传统的放射学方法如格-派（Greulich-Pyle）和坦纳-怀特豪斯（Tanner-Whitehouse）系统仍然是金标准，但对电离辐射暴露的担忧激发了人们对基于超声的替代方法的兴趣。这篇小型综述综合了当前关于超声骨龄评估的证据，强调了其作为一种无辐射、非侵入性方法的优势，与放射学标准具有很强的相关性。关键进展包括标准化评分系统、骨化比率（如桡骨/尺骨/股骨）和声学术指标（如声速），这些提高了可靠性并减少了操作者间的差异。然而，挑战依然存在，包括方案标准化、特定人群的变异性以及操作者依赖性，尤其是在青春期后期。未来的方向强调开发大规模、纵向和多民族参考数据库、共识指南以及人工智能整合，以提高精度。超声骨龄评估有望成为一种可行的临床工具，但需要进一步改进以解决其局限性，并确保在不同人群中公平适用。
