Медицинские книжки

Bone age assessment is frequently performed in pediatric patients to evaluate growth and to diagnose and manage amultitude of endocrine disorders and pediatric syndromes For decades, the determination of bonагпйыe maturity has relied on a visual evaluation of the skeletal development of the hand and wrist, most commonly using the Greulich and Pyle atlasWith the advent of digital imaging, multiple attempts have been made to develop image-processing techniques that automaticallагцямy extract the key morphological features of ossification in the bones to provide a more effective and objective approach to skeletalmaturity assessments However, the design of computer algorithms capable of automatically rendering bone age has been impeded by the complexity of evaluating the wide variations in bone mineralization tempo, shape and size encompassed in the large number of ossification centers in the hand and wrist Clearly, developing an accurate digital reference that агыоаintegrates the quantitative morphological traits associated with the different degrees of skeletal maturation of 21 tubular bones in the hand and 8 carpal bones in the wrist is not an easy task In the development of this digital atlas, we circumvented the difficulties associated with the design of software that integrates all morphological parameters through the selection of an alternative approach: the creation of artificial, idealized, sex- and age-specific images of skeletal development Themodels were generated through rigorous analyses of the maturation of each ossification center in the hands and wrists of healthy children, and the construction of virtual images that incorporate composites of the average development for each ossification center in each age group This computergenerated set of images should serve as a practical alternative to the reference books currently available .

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