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目的:检验《中国人手腕骨发育标准-中华05》的RUS-CHN和TW3-C对腕骨骨龄评价的可靠性。方法:11名有不同骨龄评价经验的评价者以RUS-CHN法评价75名儿童左手腕后前位X线片(骨龄3-18岁),其中7名评价者以TW3-C腕骨方法评价46名儿童腕骨X线片(骨龄3~13.5岁);20天后重复阅读。结果:评价者内的RUS-CHN骨发育等级评价重复率为63.4%~82.2%,单一读数的95%置信区间为±0.40岁~±0.76岁;评价者内的TW3-C腕骨等级评价重复率为65.6%~83.2%,单一读数的95%置信区间为±0.38岁~±0.71岁。评价者间的RUS-CHN等级评价重复率为61.3%~77.3%,单一读数的95%置信区间为±0.42岁~±0.96岁;评价者间的TW3-C腕骨等级评价重复率为77.4%~88.0%,单一读数的95%置信区间为±0.42岁~±0.78岁。结论:具备不同经验的评价者,其评价骨龄的可靠性有显著性差异;有经验者读片可靠性水平较高,少数无经验者通过一次学习培训可以达到有经验者的水平,但大部分无经验者的评价可靠性较低,需进一步学习与实践。
OBJECTIVE: To test the reliability of RUS-CHN and TW3-C for the evaluation of carpal bones age in Chinese Wrist Bone Development Standard - Zhonghua 05. METHODS: Totally 11 pre-operative and post-anterior radiographs (skeletal age 3-18 years) were evaluated by RUS-CHN method among 11 evaluators with different evaluation of bone age. Among them, 7 were evaluated by TW3-C carpal approach Carpal X-ray children (bone age 3 ~ 13.5 years); 20 days after repeated reading. RESULTS: The repeat rates of RUS-CHN within the evaluation ranged from 63.4% to 82.2%, and the 95% confidence intervals of single readings ranged from ± 0.40 to ± 0.76 years. The repeat rates of TW3-C carpal grading in evaluators Was 65.6% -83.2%. The 95% confidence interval for single reading was ± 0.38 years ± 0.71 years. The repeat rates of RUS-CHN ratings between evaluators were 61.3% -77.3%, 95% confidence intervals of single readings were ± 0.42 to ± 0.96 years old, and the repeatabilities of TW3-C carpal grading between evaluators were 77.4% 88.0%. The 95% confidence interval for a single reading was ± 0.42 to ± 0.78 years. Conclusion: The evaluators with different experiences have significant differences in the reliability of evaluation of skeletal age. The reliability of reading experience is high, and a few inexperienced people can achieve the level of experience through one study and training, but most of them The evaluation of inexperienced persons is less reliable and needs further study and practice.