基于颈椎CBCT影像的华东地区女性青少年手腕骨骨龄分析方法研究

目的:建立并探讨基于华东地区女性青少年颈椎锥形束CT(CBCT)影像中二维和三维增龄性形态指标的手腕骨骨龄预测模型。方法:收集华东地区150例8~16岁女性青少年的手腕X线片与颅颌面CBCT影像,测量颈椎二维和三维形态参数,并参考Fishman的手腕骨成熟指数确定骨龄分期。应用多元逐步回归分析得出三维形态参数引入前、后的骨龄模型。应用配对t检验验证模型的预测可信度,并比较两个模型的拟合优度和准确率变化。结果:年龄及第二、三、四颈椎的定量参数与手腕骨骨龄显著正相关。配对t检验结果显示,两个模型的骨龄预测值与金标准间均无显著差异(P>0.05)。引入三维形态参数后,模型的拟合优度与预测准确率均提高。结论:同时采用颈椎二维和三维形态参数建立的手腕骨骨龄预测模型,具有较好的拟合优度与预测准确率,为华东地区女性青少年手腕骨骨龄的定量研究提供了可靠依据,可作为评价个体骨骼成熟状态的有效参考。

Analysis of hand wrist bone age for female adolescents in Eastern China based on cervical vertebral cone-beam CT images

Objective:To establish and explore a predictive model for hand wrist bone age calculation based on two-dimensional(2 D)and three-dimensional(3D)morphological measurements of cervical vertebra in cone beam computerized tomography(CBCT)images.Methods:Hand-wrist X-ray images and craniofacial CBCT images of 150 Eastern Chinese female adolescents(aged from 8 to16 years)were collected,and 2 D and 3D morphological variables from cervical vertebras were measured.According to Fishman’s Skeletal Maturity Index,the stages of bone age were determined.Multiple stepwise regression analysis was used to develop two different bone age predictive formulas,excluding and including 3D measurements.The paired t-test was applied to detect the prediction reliability of the models.The adjusted R-squared and accuracy of the models excluding and including 3D measurements were analyzed and compared.Results:Age and quantitative variables of the second,third and fourth cervical vertebrae were positively correlated with bone age.The paired t-test showed that there was no significant difference between the predicted results of the two bone age formulas and the gold standard(P>0.05).The adjusted R-squared and accuracy of the formula including 3D measurements were improved compared to the formula which 3D measurements were excluded.Conclusions:The adjusted R-squared and accuracy of the hand wrist bone age predictive model formulated were improved by conjunctive using of 2 D and 3D morphological measurements,which can provide a reliable index for quantitative craniomaxillofacial growth studies in eastern Chinese female adolescents,and also a reference for individual bone maturity.