Value of Magnetic Resonance Imaging for Skeletal Bone Age Assessment in Healthy Male Children.

Abstract

Skeletal bone age assessment for medical reasons is usually performed by conventional x-ray with use of ionizing radiation. Few pilot studies have shown the possible use of magnetic resonance imaging (MRI). To comprehensively evaluate feasibility and value of MRI for skeletal bone age (SBA) assessment in healthy male children. In this prospective cross-sectional study, 63 male soccer athletes with mean age of 12.35 ± 1.1 years were examined. All participants underwent 3.0 Tesla MRI with coronal T1-weighted turbo spin echo (TSE), coronal proton density (PD)-weighted turbo spin echo (TSE), and T1-weighted three-dimensional (3D) volume interpolated breath-hold examination (VIBE) sequence. Subsequently, SBA was assessed by 3 independent blinded radiologists with different levels of experience using the common Greulich-Pyle (GP) atlas and the Tanner-Whitehouse (TW2) method. In a mean total acquisition time of 5:04 ± 0:47 min, MR image quality was sufficient in all cases. MRI appraisal was significantly faster ( P < 0.0001) by GP with mean duration of 1:22 ± 0:08 min vs. 7:39 ± 0:28 min by TW. SBA assessment by GP resulted in mean age of 12.8 ± 1.2 years, by TW 13.0 ± 1.4 years. Interrater reliabilities were excellent for both GP (ICC = 0.912 (95% confidence interval [CI] = 0.868-0.944) and TW (ICC = 0.988 (95% CI = 0.980-0.992) and showed statistical significance ( P < 0.001). Subdivided, for GP, ICCs were 0.822 (95% CI = 0.680-0.907) and 0.843 (95% CI = 0.713-0.919) in Under 12 and Under 14 group. For TW, ICCs were 0.978 (95% CI = 0.958-0.989) in Under 12 and 0.979 (95% CI = 0.961-0.989) in Under 14 group. MRI is a clinically feasible, rapidly evaluable method to assess skeletal bone age of healthy male children. Using the Greulich-Pyle (GP) atlas or the Tanner-Whitehouse (TW2) method, reliable results are obtained independent of the radiologist's experience level.