两种颈椎体高度测量方法对骨成熟度定量分析的影响

目的:比较两种测量颈椎骨体高度的方法对骨成熟度定量分析的影响,旨在为更准确地判断骨成熟度提供一个客观的依据。方法:选取10～15岁患者238例,拍摄头颅定位侧位片,采用两种方法测量第3、4颈椎体高度和中部的长度,对高度和长度的比值进行统计学分析比较。结果:将椎体中部的高度定为其下缘垂线与颈椎体上下缘交点间的距离时,其比值(H3S/AP3,H4S/AP4)拟合的曲线图不能体现出均匀改变的趋势;将椎体中部的高度定为其下缘垂线与颈椎体上缘和垂足间的距离时,其比值(H3/AP3,H4/AP4)拟合的曲线图呈现出良好的均匀上升趋势。结论:以椎体下缘垂线与颈椎体上缘和垂足间的距离作为椎体的高度(H3,H4)计算出的量化值可以更准确的预测颈椎骨成熟度。     

上海地区少年儿童颈椎骨成熟度与手腕骨成熟度的相关研究

目的:通过评价上海地区少年儿童颈椎骨成熟度和手腕骨成熟度的相关性,探讨利用颈椎骨成熟度评判生长发育阶段的可行性。方法:样本包括上海地区170例5～18岁(男52例,女118例)正畸就诊患者。治疗前同期摄取左手腕掌指骨片和头颅侧位定位片,分别评价手腕骨成熟度和颈椎骨成熟度(手腕骨采用Grave和Brown法,颈椎骨采用Hassel和Farman改良分期法)。以SPSS11.0统计软件包进行相关性分析(Spearman法)。结果:颈椎骨成熟度和手腕骨成熟度具有高度相关性。男性组r=0.858(P<0.01),女性组r=0.882(P<0.01);男女合并r=0.918(P<0.01)。结论:在正畸治疗中,头颅侧位定位片上的颈椎骨成熟度可作为判断少年儿童生长发育阶段的可靠指标。     

中国1 076名儿童及青年腭中缝影像学分期与其颈椎骨龄分期的相关性研究

目的:通过锥形束CT研究中国儿童及青年腭中缝分期（midpalatal suture stage,MPS）与颈椎骨龄分期（cervical vertebral maturation stage,CS）的相关性,探讨CS对腭中缝骨化闭合程度的预测能力。方法:回顾性收集2013年1月至2018年4月于北京大学口腔医学院·口...     

腕骨骨龄与颈椎骨龄相关性的研究

目的研究腕骨骨龄与颈椎骨龄的相关性.方法随机抽取177名8～29岁临床正畸患者,同期拍摄左手腕骨片和头颅侧位片,分别进行腕骨骨龄与颈椎骨龄的评定,然后进行相关分析.结果腕骨骨龄与颈椎骨龄具有高度相关性,相互转化的回归方程为:Y=35.052 3.549X(Y:腕骨骨龄,X:颈椎骨龄).结论本研究完善了腕骨骨龄和颈椎骨龄的评定方法,实现了两种骨龄的相互转换,为进一步研究提供基础.     

颈椎骨龄定量分期法在评估前后面高生长发育中的初步应用

Objective To investigate the longitudinal changes of facial height according to quantitative cervical vertebral maturation (QCVM) for adolescents with normal occlusion. Methods Mixed longitudinal data were used. The samples included 87 adolescents aged 8～18 years with normal occlusion (32 males, 55 females) selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year for 6 years. The growth magnitude (GM), relative growth rate (RGR) and the percentage of facial growth remaining (PGR) of facial height parameters according to QCVM were measured and analyzed. Results ①The largest GM was happened during the period of high velocity in QCVM Ⅱ for both genders, and the least GM was during the period of completing velocity in QCVM Ⅳ. The next largest growth was during the period of accelerating velocity in QCVM Ⅰ with the exception of Ar-Go and male S-Go parameters, which were during the period of decelerating velocity in QCVM Ⅲ. ②All measurements showed a trend towards accelerating velocity→ high velocity→decelerating velocity→ completing velocity from QCVM stageⅠto stage Ⅳ. The largest RGR was all in QCVM Ⅱ, then in QCVMⅠ, and the least was in QCVM Ⅳ. ③Both sexes completed similar percentages of total growth at comparable QCVM stage, even though there were significant gender differences in GM and RGR. Conelusions QCVM could be used to assess the level of skeletal maturation during adolescence, to estimate RGR and predict PGR.     

颈椎骨龄定量分期法在评估前后面高生长发育中的初步应用

目的 以颈椎骨龄定量分期法（quantitative cervical vertebral maturation,QCVM）为划分标准,探讨QCVM Ⅰ至Ⅳ期前后面高生长发育的纵向变化特点.方法 从901位中小学生中挑选87位（女55,男32）正常（牙合）个体,每年定期拍摄正中（牙合）位头颅侧位片及手腕骨片,连续6年,组成8-18岁混合纵向资料,比较QCVM Ⅰ至Ⅳ期前后面高的生长量、相对生长速率和生长完成百分比.结果 ①所有面高参数最大平均生长量均处于高峰期（第Ⅱ期）,最小生长量均处于结束期（第Ⅳ期）;第二大生长量除下颌升支高度及男性后面高处于减速期（第Ⅲ期）,其余均为加速期（第Ⅰ期）;②所有参数从QCVM Ⅰ至Ⅳ期呈现加速→高峰→减速→结束的生长趋势,最大相对生长速率均发生在第Ⅱ期（高峰期）,第Ⅰ期（加速期）次之;③虽然在生长量和相对生长速率上存在男女性别差异,但男女在颈椎发育的不同阶段完成相似的生长百分比.结论 颈椎骨龄定量分期法能评估前后面高的发育阶段、估计生长速率、预测生长剩余百分比,有重要的临床应用价值.     

A comparison of skeletal maturation in patients with tooth agenesis and unaffected controls assessed by the cervical vertebral maturation (CVM) index

Abstract

Objective: The aims of this study were to (1) investigate if there is a difference in skeletal maturation between tooth agenesis and control patients and (2) whether skeletal maturation is affected by the severity of tooth agenesis. The cervical vertebral maturation (CVM) index can be used to assess skeletal maturation.

Design: A retrospective cross-sectional study.

Setting: Eastman Dental Hospital, London, UK.

Methods and materials: A total of 360 cephalograms of patients aged 9–17 years (164 males and 196 females) allocated to four subgroups (mild, moderate and severe tooth agenesis patients, and controls) were assessed retrospectively. There were 90 patients in each of the four subgroups. The skeletal maturation of each subject was assessed both quantitatively and qualitatively using the CVM index. All patients in the study were either currently receiving treatment or had been discharged from the hospital.

Results: There was no statistically significant relationship between skeletal maturation and the presence of tooth agenesis. Furthermore, there was no statistically significant relationship between the skeletal maturity of patients and different severities of tooth agenesis.

Conclusions: The data obtained from this group of patients and using this measurement tool alone does not supply sufficient reason to reject the null hypothesis. However, it suggests that it is possible that no difference exists between the groups.     

Neural networks for classification of cervical vertebrae maturation: a systematic review

ObjectiveTo assess the accuracy of identification and/or classification of the stage of cervical vertebrae maturity on lateral cephalograms by neural networks as compared with the ground truth determined by human observers.Materials and MethodsSearch results from four electronic databases (PubMed [MEDLINE], Embase, Scopus, and Web of Science) were screened by two independent reviewers, and potentially relevant articles were chosen for full-text evaluation. Articles that fulfilled the inclusion criteria were selected for data extraction and methodologic assessment by the QUADAS-2 tool.ResultsThe search identified 425 articles across the databases, from which 8 were selected for inclusion. Most publications concerned the development of the models with different input features. Performance of the systems was evaluated against the classifications performed by human observers. The accuracy of the models on the test data ranged from 50% to more than 90%. There were concerns in all studies regarding the risk of bias in the index test and the reference standards. Studies that compared models with other algorithms in machine learning showed better results using neural networks.ConclusionsNeural networks can detect and classify cervical vertebrae maturation stages on lateral cephalograms. However, further studies need to develop robust models using appropriate reference standards that can be generalized to external data.     

上海地区216例青少年年龄与颈椎骨成熟度关系的研究

目的:探讨青少年年龄与颈椎骨成熟度间的相关性。方法:采用双盲法,对216例10～20岁青少年的X线头颅侧位定位片,采用SAS6.12统计软件分析C2～C5颈椎体生长发育的状态,与年龄间的相互关系以及性别间有无差异。结果:随着年龄增长,C2～C5颈椎骨形态呈规律性变化,女性比男性约提前2a,在11岁和12岁年龄段有统计学差异,但形态变化无性别差异。青春快速生长发育期的开始时间和高峰期时间,个体差异大。结论:用头颅侧位片观察颈椎骨的形态变化判断儿童的生长发育状态,比用年龄来判断快速生长期更为准确,是临床上简便可行的方法。     

上海地区男性少年儿童颈椎骨骨龄的测量分析

目的建立并探讨上海地区男性少年儿童颈椎骨龄的测量方法。方法随机选择上海地区240名8-15岁男性少年儿童X线头颅侧位定位片,参考Mito的颈椎骨龄测量计算法并加以改进,对第三、四颈椎体进行测量分析,应用多元逐步回归分析得出颈椎骨龄计算方法。结果第三、四颈椎体各测量项目随年龄的增长呈现规律性变化,建立颈椎骨龄计算回归方程为Y=-4．968＋4．250AH4／AP4＋10．041AH3／H3＋6．184Ha／AP3（r=O．882）。结论应用本研究建立的方法计算出的颈椎骨龄可作为上海地区男性少年儿童颌面部生长发育的评价指标,为正畸临床提供参考。     

Visual assessment of the cervical vertebral maturation stages: A study of diagnostic accuracy and repeatability

Objective:To evaluate the diagnostic accuracy and repeatability of the visual assessment of the cervical vertebral maturation (CVM) stages.Materials and Methods:Ten operators underwent training sessions in visual assessment of CVM staging. Subsequently, they were asked to stage 72 cases equally divided into the six stages. Such assessment was repeated twice in two sessions (T1 and T2) 4 weeks apart. A reference standard for each case was created according to a cephalometric analysis of both the concavities and shapes of the cervical vertebrae.Results:The overall agreement with the reference standard was about 68% for both sessions and 76.9% for intrarater repeatability. The overall kappa coefficients with the reference standard were up to 0.86 for both sessions, and 0.88 for intrarater repeatability. Overall, disagreements one stage and twp stage apart were 23.5% (T1) and 5.1% (T2), respectively. Sensitivity ranged from 53.3% for CS5 (T1) to 99.9% for CS1 (T2), positive predictive values ranged from 52.4% for CS5 (T2) to 94.3% for CS6 (T1), and accuracy ranged from 83.6% for CS4 (T2) to 94.9% for CS1 (T1).Conclusions:Visual assessment of the CVM stages is accurate and repeatable to a satisfactory level. About one in three cases remain misclassified; disagreement is generally limited to one stage and is mostly seen in stages 4 and 5.     

下颌后缩与I类骨型女童骨龄比较

目的探讨女性儿童下颌后缩患者的骨成熟度与I类骨型错殆畸形患者比较是否具有差异性,分析下颌后缩与骨发育成熟的早晚是否存在相关性。方法随机选择下颌后缩28例和I类骨型错殆患者47例,均为女性,年龄10一12．9岁,测量其颈椎骨龄,比较两组间颈椎骨龄以及颈椎骨龄年龄差有无差异性。结果下颌后缩组平均颈椎骨龄为11．40,平均年龄骨龄差为0．35,I类骨型组平均颈椎骨龄为11．78,平均年龄骨龄差为0．56,两组问颈椎骨龄和年龄骨龄差均无显著性差异,下颌后缩组患者的颈椎骨发育相对于I类骨型组患者有轻微推后的趋势。结论下颌后缩与I类骨型错殆畸形女童的骨龄没有显著性差异,下颌后缩与骨骼发育的早晚不存在明显的相关性。     

单侧完全性唇腭裂患者牙龄骨龄相关性的研究

目的 探讨单侧完全性唇腭裂（UCLP）患者牙龄（DCS）和颈椎骨龄（CVMS）间关系,为唇腭裂（CLP）患者选择治疗时间提供理论基础。方法 选择UCLP患者123名,非CLP患者215名。通过Demirjian法评估非CLP患者下颌左侧和UCLP患者下颌双侧尖牙,前磨牙及第二磨牙的DCS;通过Baccetti法观测CVMS。将DCS和CVMS分布行Spearman相关分析,并对相关性进行比较。结果 非CLP患者和UCLP患者的所有DCS和CVMS均具有显著相关性（非CLP患者r=0.762~0.864,P<0.05;UCLP患者r=0.809~0.914,P<0.05）。其中,UCLP患者下颌第一前磨牙DCS和CVMS相关性最高。除UCLP女性前磨牙外,其余牙齿DCS和CVMS的相关性同非CLP患者间无统计学差异（P>0.05）。结论 DCS可以作为判定UCLP患者生长发育的生物学指标。其中,下颌第一前磨牙的DCS和CVMS相关性最大。     

Correlation between salivary dehydroepiandrosterone sulfate (DHEA-S) levels and cervical vertebral maturation in Saudi individuals

BackgroundGrowth incidents usually progress in a fairly expected sequence; however, their timing and pattern vary across individual subjects. Biochemical biomarkers have an association with bone metabolism and produce signals which stimulate the growth and development of various craniofacial structures. Steroid dehydroepiandrosterone sulfate (DHEA-S) plays a major role in the initiation of growth hormone actions which has a significant role in promoting and accelerating skeletal maturation during puberty. The aim of this study was to investigate the correlation between salivary DHEA-S levels and cervical vertebral maturation (CVM) stages throughout the circumpubertal developmental period.MethodsOne hundred forty-one participants (70 males and 71 females), between 7 and 23years of age, were categorized into six cervical stages (CS) based on lateral cephalograms. Using a passive drooling technique, unstimulated whole saliva samples were collected from all enrolled subjects. DHEA-S levels were analyzed using the enzyme-linked immunosorbent assay (ELISA) and correlated with the six CVM stages.ResultsOne-way analysis of variance ANOVA showed that the mean salivary DHEA-S levels at CS 3 and CS 4 were significantly different from the values recorded at other stages, and the two stages were statistically significant from each other. Pearson linear correlation of mean salivary DHEA-S levels from CS 1 to CS 6 showed a significant positive correlation.ConclusionSalivary DHEA-S can be used as a non-invasive indicator for detecting the pubertal growth spurt.