골연령 판독 방법의 비교 아이맘 소아과 조 주래.

Presentation on theme: "골연령 판독 방법의 비교 아이맘 소아과 조 주래."— Presentation transcript:

1 골연령 판독 방법의 비교 아이맘 소아과 조 주래

2 Ossification time

3

4 골연령 판독방법 (1) in pubmed X-ray 이용 Greulich – Pyle atlas (hand-wrist)
TW3 method (hand-wrist) Roche-Wainer-Thissen (knee) FELS (hand) Harnack (lower leg) Risser’s sign (iliac crest apophysis)

5 골연령 판독방법 (2) in pubmed X-ray 이용 초음파 이용 Dental (lower 3rd molar)
Root development stage Root length Cervical vertebra maturation index 초음파 이용 Sunlight BonAge (Israel) Fetal age Calcaneal volume

6 Greulich – Pyle atlas 구입방법 : 교보문고 외서파트.

7 1931-1942, White children, USA Male standard Female standard
Greulich – Pyle atlas 01 , White children, USA (Todd atals) Male standard 31 standard : 0-19 years Female standard 27 standard : 0-18 years Study series : 1년까진 3개월, 5세까진 6개월, 이후엔 1년마다 Standard의 결정 : 100장의 film을 ossification center의 발달에 따라 배열후 중앙값을 가지는 것을….

8 Same Sex, Age atlas Most resemble Maturity indicators
Greulich – Pyle atlas 02 Same Sex, Age atlas Most resemble Maturity indicators 16 parts (radius, ulna, capitate & hamate, triquetral & pisiform, lunate, scaphoid, trapezium & 1st metacarpal, trapezoid & 2nd metacarpal base, metacarpal, 5th metacarpal, proximal phalanx of thumb, proximal phalanges, 5th proximal phalanx, 3-4 middle phalanges, distal phalanx of thumb, distal phalanges)

9 Greulich – Pyle atlas 03

10 Greulich – Pyle atlas 04

11 Prediction of adult height
Greulich – Pyle atlas 05 Prediction of adult height

12 Prediction of adult height
Greulich – Pyle atlas 06 Prediction of adult height Average Within 1 year Accelerated More than 1 year Retarded

13 Greulich – Pyle atlas 06

14 TW3 method

15 TW3 method 1954 – 1976, Zurich study RUS, Carpal Boys : 2.0 – 16.5 yr
Male 137, Female 137 RUS, Carpal Boys : 2.0 – 16.5 yr Girls : 2.0 – 15.0 yr

16 TW3 method Prediction of adult height TW2 method Boy : over 10 years
Girl : over 7 years Menarch : 12 years TW2 method RUS, Carpal, TW20 Height increment

17 GP vs. TW3 GP TW3 미국 중산층 쉽다 빠르다 인종, 환경에 따른다 정확도의 범위가 제한 뼈에 따라 골연령변화
고정된 atlas TW3 스위스 경험이 필요 정확하다 시간이 걸린다 정확한 사진이 필요 판독때마다 달라진다 개정판

18 CASMAS Publisher Kinbara publication Author name Bone maturity research group / work Effective date ISBN cord/code Price (including tax) 7,140 Yen

19 CASMAS

20 CASMAS

21 Sunlight BonAge

22 Sunlight BonAge

23 Accuracy of Skeletal Age Assessment in Children From Birth to 6 Years of Age With the Ultrasonographic Version of the Greulich-Pyle Atlas Boys 71.1% : same age 84.4% : less than 6 months Girls 65.5% : same age 88.5% : less than 6 months J Ultrasound Med : ; Turkey

24 Assessment of skeletal age at the wrist in children with a new ultrasound device
6-17 years Pearson correlation coefficient = 0.82 1.0 +/- 0.8 years Pediatr Radiol Feb 24

25 Dual-energy X-ray absorptiometry (DXA)
2005, Poland Hand scan Total body bone mineral density (BMD)

26 Computer aided assessment
Bone Age 1.65 CAD CASAS CASMAS Web base Digital bone age atlas (UCLA) Bone Age assessment (Japan) Tanner-Whitehouse test

27 Bone age (for Mac OsX)

28 Digital bone age atlas

29 CAD system (Brazil)

30 CASAS (Canada)

31 Digital SAAS (beta)

32 Digital SAAS (beta)

33 Bone Age assessment

34 Tanner-Whitehouse test

35 Tanner-Whitehouse test

36 감사합니다.