Comparison Of Clinical Apllication Of Bone Age Assessment In Children With Ghd Using TW2and TW3, Two Bone Age Assessment Methods

Objectives Compare diagnostic values of growth hormone deficiency (GHD) children by two bone age assessment methods (TW2and TW3).Methods We selected diagnosed GHD children as Case group and normal children (height±1SD) as normal group. The x-ray films of the left-hand at their first visit were analyzed retrospectively and the bone age of two groups were assessed with two standards methods, TW2and TW3, respectively. The difference between bone age and height age were compared, and then ROC.curve was applied to the assessment of diagnostic value of these two methods.Results Normal group of69cases, age3.7to15.6(9.86±2.50) years, the group of children of normal height age (139.62±14.35) cm, the actual height (138.38±14.52) cm, between two groups were no significant difference (P=0.10). GHD children65cases of control group, the age of3.4～17.2(9.44±3.20) years of age, the highest concentration of8-10age group;19cases of female children, aged (9.09±3.04)years old,46cases of male patients, age (9.71±3.19) years old, there was no significant difference in age between two groups (P=0.83), but there was significant difference in sex between two groups (P=0.00). In normal group, there was no significant difference in assessment of bone age and height age using both TW2and TW3methods (P=0.21), but there was statistically significant in case group (P=0.00). However, bone age and height age assessed by TW3method was less difference than those by TW2in either normal group or case group. Therefore, there was statistically significant (P=0.00and P=0.04). The ROC curve showed that area under ROC curve in TW3was greater than TW2and its difference was statistically significant (Z=6.14, P=0.00). During diagnosis of GHD children, using TW3method detected bone age, its specificity was66.2%and its sensitivity was85.5%.Conclusion The bone age evaluation of normal children and GHD children has a diagnostic value in both TW2and TW3methods, but TW3method was more suitable for bone age evaluation of GHD children. GHD children of distal ulna ossification center is delayed.