The Reliability of Using Greulich-Pyle Method to Determine Children's Bone Age in Taiwan

以Greulich-Pyle法評估台灣兒童骨齡的可靠性

江國賢(Kuo-Hsien Chiang) ； 周紹賓(Andy Shau-Bin Chou) ； 嚴寶勝(Pao-Sheng Yen) ； 凌昌明(Chang-Ming Ling) ； 林昭君(Chao-Chun Lin) ； 李超群(Chau-Chin Lee) ； 張寶源(Pau-Yang Chang)

《慈濟醫學雜誌》 17卷6期 (2005/12) Pp. 417-420

https://doi.org/10.6440/TZUCMJ.200512.0417

摘要

目的：Greulich-Pyle骨骼生長圖譜是以1917年至1942年在美國的兒童資料完成，常用來評估骨骼的成熟情形。在這個研究中，我們探討Greulich-Pyle法是否適用於台灣兒童骨齡的評定。材料與方法：左手及腕部的X光片取得自478個兒童因為外傷至急診或骨科就診。研究對象包含了370個兒童（140個女孩、230個男孩），平均年齡為10.31歲。這些X光片由兩位放射科醫師分析。他們都不知道這些兒童的真實年齡。結果：在2-12歲男孩中平均骨齡較實際年齡少0.22-1.86歲，在13-18歲男孩中平均骨齡則較實際年齡多0.13-1.28歲。在2-8歲女孩中平均骨齡較實際年齡少0.19-0.84歲，在9-17歲女孩中平均骨齡則較實際年齡多0.18-1.48歲。結論：我們的結果顯示在青春期前有骨齡遲緩，青春期之後則會有骨齡超前。在某些年齡層實際年齡及骨齡會有1年以上的差距。對Greulich-Pyle圖譜作一些修正可以增加我們在骨齡評估上的準確度及可信度。

關鍵字

骨齡 ； Greulich-Pyle法 ； X光攝影術

並列摘要

Objective: The Greulich-Pyle Atlas of skeletal maturation has been prepared using data from children born between 1917 and 1942 in the USA, and is frequently used for assessment of skeletal maturity. In this study, we investigated whether or not the Greulich-Pyle method is sufficient for the determination of the skeletal age of children in Taiwan. Materials and Methods: Plain radiographs of the left hand and wrist were obtained from 478 children who came to the emergency department or orthpedic outpatient department because of suspected trauma. The study group consisted of 370 children (140 girls, 230 boys), with a mean age of 10.31 years. These radiographs were analysed by two radiologists who were unaware of the age of the children. Results: Mean skeletal ages were delayed by approximately 0.22 to 1.86 years compared to the mean chronological ages in boys aged 2 to 12 years and advanced by 0.13 to 1.28 months in boys aged 13 to 18 years. Mean skeletal ages were delayed by approximately 0.19 to 0.84 months compared to the mean chronological ages in girls aged 2 to 8 years and advanced by 0.18 to 1.48 months in girls aged 9 to 17 years. Conclusions: Our results show a retardation of bone age before puberty followed by an increase at puberty, resulting in advancement by the end of puberty. Also, there is a discrepancy of more than one year between the chronological age and the measured bone age in some age groups. We believe that some modification of the Greulich-Pyle Atlas is necessary to enhance our ability to determine skeletal maturation with accuracy, reliability and consistency.

並列關鍵字

bone age ； Greulich-Pyle method ； radiography