Abstract：
BACKGROUND: Rapid adolescent growth is associated with an increased risk of disease and disease progression. This study assesses the reliability and validity of non-ionising B-mode ultrasound for the assessment of skeletal maturity (Risser Grade) and offers procedural guidelines for its use.
METHODS: Twenty-three female adolescents with primary-right-thoracic scoliosis (age: 13.8 (1.6) years) and twenty age-matched female control participants without scoliosis (age: 13.1 (1.8) years) were recruited. Skeletal maturity was determined from (i) a series of nine B-mode ultrasound images collected at sites equally spaced between the anterior and posterior superior iliac spines of the pelvis and (ii) clinical spine radiographs obtained as part of standard scoliosis care. Inter-rater reliability was assessed between a novice researcher and an experienced medical doctor. Concurrent-validity was assessed by comparing the location and degree of apophysis growth and fusion obtained via ultrasound with that obtained using radiograph Risser grading for scoliosis participants only.
RESULTS: The inter-rater reliability of ultrasound Risser grading was strong [ICC(2,1): 0.99, p < 0.001]. High concurrent-validity was determined, with no difference in Risser grading identified between the radiograph and ultrasound grading methods (Wilcoxon signed-rank: Z = -1.93, p = 0.053).
CONCLUSIONS: Ultrasound provides a reliable non-ionising alternative to the gold standard of Risser grading from radiographs to determine and monitor skeletal maturity. This study provides a detailed methodology for using ultrasound to assess skeletal maturity.
CONCLUSIONS: Rapid adolescent growth is associated with an increased risk of disease and disease progression. Therefore, accurately determining and monitoring skeletal maturity in these adolescents is crucial. This study assesses the reliability and validity of non-ionising B-mode ultrasound for the assessment of skeletal maturity and offers procedural guidelines for its use.
METHODS: Twenty-three female adolescents with primary-right-thoracic scoliosis (age: 13.8 (1.6) years) and twenty age-matched female control participants without scoliosis (age: 13.1 (1.8) years) were recruited. Skeletal maturity was determined from (i) a series of nine B-mode ultrasound images collected at sites equally spaced between the anterior and posterior superior iliac spines of the pelvis and (ii) clinical spine radiographs obtained as part of standard scoliosis care. Inter-rater reliability was assessed between a novice researcher and an experienced medical doctor. Concurrent-validity was assessed by comparing the location and degree of apophysis growth and fusion obtained via ultrasound with that obtained using radiograph Risser grading for scoliosis participants only.
RESULTS: The inter-rater reliability of ultrasound Risser grading was strong [ICC(2,1): 0.99, p < 0.001]. High concurrent-validity was determined, with no difference in Risser grading identified between the radiograph and ultrasound grading methods (Wilcoxon signed-rank: Z = -1.93, p = 0.053).
CONCLUSIONS: Ultrasound provides a reliable non-ionising alternative to the gold standard of Risser grading from radiographs to determine and monitor skeletal maturity. This study provides a detailed methodology for using ultrasound to assess skeletal maturity.
CONCLUSIONS: Rapid adolescent growth is associated with an increased risk of disease and disease progression. Therefore, accurately determining and monitoring skeletal maturity in these adolescents is crucial. This study assesses the reliability and validity of non-ionising B-mode ultrasound for the assessment of skeletal maturity and offers procedural guidelines for its use.
摘要：
背景：青少年的快速成长与疾病和疾病进展的风险增加有关。这项研究评估了非电离B型超声评估骨骼成熟度（RisserGrade）的可靠性和有效性，并提供了使用的程序指南。
方法：招募了23名患有原发性右胸椎侧凸的女性青少年（年龄：13.8（1.6）岁）和20名年龄匹配的无脊柱侧凸的女性对照参与者（年龄：13.1（1.8）岁）。骨骼成熟度是根据（i）在骨盆的前和后上棘之间等距的位置收集的一系列9张B模式超声图像和（ii）作为标准脊柱侧凸护理的一部分获得的临床脊柱X光片确定的。在新手研究人员和经验丰富的医生之间评估了评估者之间的可靠性。通过比较超声获得的骨生长和融合的位置和程度与仅使用脊柱侧凸参与者的X射线Risser分级获得的位置和程度来评估并发有效性。
结果：超声Risser分级的评分者间可靠性很强[ICC（2,1）：0.99，p<0.001]。确定了高并发有效性，射线照片和超声分级方法之间的Risser分级没有差异（Wilcoxonsigned-rank：Z=-1.93，p=0.053）。
结论：超声提供了一种可靠的非电离替代方案，以确定和监测骨骼成熟度。这项研究提供了使用超声波评估骨骼成熟度的详细方法。
结论：青少年快速成长与疾病和疾病进展的风险增加有关。因此,准确确定和监测这些青少年的骨骼成熟度至关重要.本研究评估了非电离B型超声评估骨骼成熟度的可靠性和有效性，并为其使用提供了程序指南。
方法：招募了23名患有原发性右胸椎侧凸的女性青少年（年龄：13.8（1.6）岁）和20名年龄匹配的无脊柱侧凸的女性对照参与者（年龄：13.1（1.8）岁）。骨骼成熟度是根据（i）在骨盆的前和后上棘之间等距的位置收集的一系列9张B模式超声图像和（ii）作为标准脊柱侧凸护理的一部分获得的临床脊柱X光片确定的。在新手研究人员和经验丰富的医生之间评估了评估者之间的可靠性。通过比较超声获得的骨生长和融合的位置和程度与仅使用脊柱侧凸参与者的X射线Risser分级获得的位置和程度来评估并发有效性。
结果：超声Risser分级的评分者间可靠性很强[ICC（2,1）：0.99，p<0.001]。确定了高并发有效性，射线照片和超声分级方法之间的Risser分级没有差异（Wilcoxonsigned-rank：Z=-1.93，p=0.053）。
结论：超声提供了一种可靠的非电离替代方案，以确定和监测骨骼成熟度。这项研究提供了使用超声波评估骨骼成熟度的详细方法。
结论：青少年快速成长与疾病和疾病进展的风险增加有关。因此,准确确定和监测这些青少年的骨骼成熟度至关重要.本研究评估了非电离B型超声评估骨骼成熟度的可靠性和有效性，并为其使用提供了程序指南。
