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青少年における膝と手首の骨年齢の不一致:骨格の成熟度評価と甲状腺刺激ホルモンレベルとの関連
Yuxin Sun1,2, Zhibo Zhou2, Xueqing Zheng3
1Eight-Year Program of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Pediatric radiology
|September 2, 2025
まとめ
膝のMRIは,従来の手と手首のX線と比較して,成長遅延の青少年における骨格の成熟度をより信頼できる評価を提供します. この非放射的方法は,甲状腺刺激ホルモン (TSH) レベルが上昇した患者の最終的な身長を予測するのに特に有用です.
科学分野:
- 小児内分泌学
- 放射線科
- 青春期 医学
背景:
- 従来の手と手首のX線写真では,思春期の後の骨格年齢 (BA) が正確に反映されない場合があります.
- 膝の磁気共鳴画像 (MRI) は,下肢の骨格の詳細な評価のための非放射性代替を提示します.
研究 の 目的:
- サンディエゴのMRIベースの膝のBAアトラスを,成長減速の中国人のコホートで検証する.
- 膝と手首のBA評価の合致を評価する
- 膝と手首の間のBA測定の不一致に影響を与える臨床的要因を特定する.
主な方法:
- 手と手首のX線写真 (グリーリッヒとパイルのアトラス) と膝のMRI (サンディエゴのアトラス) を用いて227人の青少年を評価した.
- 膝のBA,手首のBA,および時間的年齢 (CA) の間の相関を分析した.
- 膝と手首のBAとの差異に関連した臨床的要因を調査した.
主要な成果:
- 膝のBAは,手首のBA (rs=0.763) よりも時間的年齢との強い相関を示した.
- 膝のBAとCAの平均差 (0. 71 ± 1. 06年) は,手腕のBAとCAの平均差 (1. 08 ± 1. 19年) よりも小さかった.
- 甲状腺刺激ホルモン (TSH) 濃度の上昇はBA不一致と関連しており,サブクリニック性甲状腺機能低下は膝の骨老化のリスクを高めていた (OR=6. 022).
結論:
- 膝のMRIは,成長遅延を経験する若者の骨格の成熟度を評価するための信頼できる方法です.
- 手と手首と膝のBAの間には適度な相関関係がありますが,膝のMRIは優れた予測値を提供することができます.
- TSHが上昇した若者では,正確な成長の可能性の評価と治療指針のために,膝のMRIが推奨されます.
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