基于CBCT三维形态分析的中国青少年颈椎骨成熟度定量方法研究

doi:10.13591/j.cnki.kqyx.2024.05.001

Abstract

Abstract:

Objective To investigate associations between three-dimensional(3D) morphology of cervical vertebrae and skeletal maturation by cone-beam computed tomography(CBCT) and establish corresponding regression models for quantitatively evaluating cervical vertebral maturation(CVM). Methods The analyzed sample consisted of 358 CBCT images (175 male, 183 female), of which 277 images were randomly selected as the model development group and 81 as the performance test group. Twenty-one 3D morphological parameters were defined and measured, incorporating all parts of the cervical vertebrae, including the cervical vertebral bodies, transverse processes, spinous processes, pedicles, lamina, and articular processes. The cervical vertebral maturation index (CVMI) was determined by experienced orthodontists as reference standard. Spearman’s rank correlation coefficient and multivariable stepwise regression analysis were used to identify the associations and build regression models. The performance test group was employed to examine each model’s reliability. Paired-samples Wilcoxon signed-rank test compared the CVMI of the model prediction with the reference standard. Results Three-dimensional morphological changes in various parts of the cervical vertebrae correlated with CVMI (P<0.05). Six 3D morphometric parameters were each recognized for male and female models, three of which were identical. The adjusted R² was 0.899 for males and 0.902 for females, with corresponding accuracies of 85.0% and 85.4%, respectively. These models showed no difference as compared with the reference standard (P>0.05). Conclusion New associations were found between 3D morphology of cervical vertebrae and skeletal maturation. The 3D-driven morphometric CVM assessment method and corresponding regression models exhibited good credibility and high consistency with experts.

Key words: skeletal maturation, cervical vertebrae maturation index, three-dimensional morphology, cone-beam computed tomography

CLC Number:

R783.5

WU Yue, TANG Wen, ZHANG Yuyanran, YUAN Weiyu, PAN Yifei, CHEN Xinyu, XU Haiyang, LYU Yunfan, IZADIKHAH Iman, CAO Dan, XIE Lizhe, YAN Bin. Quantitative analysis of cervical vertebral maturation in Chinese adolescents based on three-dimensional morphology of cervical vertebrae[J]. Stomatology, 2024, 44(5): 321-328.

Figures/Tables 7

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References 30

[1]	Lee YS, Choi SH, Kim KH, et al. Evaluation of skeletal maturity in the cervical vertebrae and hand-wrist in relation to vertical facial types[J]. Korean J Orthod, 2019, 49(5):319-325.
[2]	Baccetti T, Franchi L, Jr McNamara JA. An improved version of the cervical vertebral maturation(CVM)method for the assessment of mandibular growth[J]. Angle Orthod, 2002, 72(4):316-323. doi: 10.1043/0003-3219(2002)072<0316:AIVOTC>2.0.CO;2 pmid: 12169031
[3]	Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae[J]. Am J Orthod Dentofacial Orthop, 1995, 107(1):58-66.
[4]	Cericato GO, Bittencourt MAV, Paranhos LR. Validity of the assessment method of skeletal maturation by cervical vertebrae: A systematic review and meta-analysis[J]. Dentomaxillofac Radiol, 2015, 44(4):20140270.
[5]	Ferrillo M, Curci C, Roccuzzo A, et al. Reliability of cervical vertebral maturation compared to hand-wrist for skeletal maturation assessment in growing subjects: A systematic review[J]. J Back Musculoskelet Rehabil, 2021, 34(6):925-936.
[6]	Byun BR, Kim YI, Yamaguchi T, et al. Quantitative assessment of cervical vertebral maturation using cone beam computed tomography in Korean girls[J]. Comput Math Methods Med, 2015, 2015: 405912.
[7]	Byun BR, Kim YI, Yamaguchi T, et al. Quantitative skeletal maturation estimation using cone-beam computed tomography-generated cervical vertebral images: A pilot study in 5-to 18-year-old Japanese children[J]. Clin Oral Investig, 2015, 19(8):2133-2140.
[8]	Chen LL, Xu TM, Jiang JH, et al. Quantitative cervical vertebral maturation assessment in adolescents with normal occlusion: A mixed longitudinal study[J]. Am J Orthod Dentofacial Orthop, 2008, 134(6):720.e1-720720. e7;discussion 720-721.
[9]	Altan M, NebioğluDalcı Ö, İşeri H. Growth of the cervical vertebrae in girls from 8 to 17 years. A longitudinal study[J]. Eur J Orthod, 2012, 34(3):327-334.
[10]	Echevarría-Sánchez G, Arriola-Guillén LE, Malpartida-Carrillo V, et al. Reliability of cephalograms derived of cone beam computed tomography versus lateral cephalograms to estimate cervical vertebrae maturity in a Peruvian population: A retrospective study[J]. Int Orthod, 2020, 18(2):258-265.
[11]	Pauwels R, Araki K, Siewerdsen JH, et al. Technical aspects of dental CBCT: State of the art[J]. Dentomaxillofac Radiol, 2015, 44(1):20140224.
[12]	Gandini P, Mancini M, Andreani F. A comparison of hand-wrist bone and cervical vertebral analyses in measuring skeletal maturation[J]. Angle Orthod, 2006, 76(6):984-989. doi: 10.2319/070605-217 pmid: 17090154
[13]	Khanagar SB, Al-Ehaideb A, Maganur PC, et al. Developments, application, and performance of artificial intelligence in dentistry-A systematic review[J]. J Dent Sci, 2021, 16(1):508-522. doi: 10.1016/j.jds.2020.06.019 pmid: 33384840
[14]	Ezra D, Masharawi Y, Salame K, et al. Demographic aspects in cervical vertebral bodies' size and shape(C3-C7):A skeletal study[J]. Spine J, 2017, 17(1):135-142.
[15]	Saluja S, Patil S, Vasudeva N. Morphometric analysis of sub-axial cervical vertebrae and its surgical implications[J]. J Clin Diagn Res, 2015, 9(11):AC01-AC04.
[16]	Panjabi MM, Duranceau J, Goel V, et al. Cervical human vertebrae. Quantitative three-dimensional anatomy of the middle and lower regions[J]. Spine, 1991, 16(8):861-869. doi: 10.1097/00007632-199108000-00001 pmid: 1948369
[17]	Lazakidou AA. Handbook of research on informatics in healthcare and biomedicine[M]. Pennsylvania IGI Global, 2006.
[18]	Gabriel DB, Southard KA, Qian F, et al. Cervical vertebrae maturation method: Poor reproducibility[J]. Am J Orthod Dentofacial Orthop, 2009, 136(4):478.e1-478. e7;discussion 478-480.
[19]	Dai XB, Bai JN, Liu TL, et al. Limited-view cone-beam CT reconstruction based on an adversarial autoencoder network with joint loss[J]. IEEE Access, 2018, 7: 7104-7116.
[20]	Mito T, Sato K, Mitani H. Cervical vertebral bone age in girls[J]. Am J Orthod Dentofacial Orthop, 2002, 122(4):380-385.
[21]	San Román P, Palma JC, Oteo MD, et al. Skeletal maturation determined by cervical vertebrae development[J]. Eur J Orthod, 2002, 24(3):303-311.
[22]	McNamara JA Jr, Franchi L. The cervical vertebral maturation method: A user’s guide[J]. Angle Orthod, 2018, 88(2):133-143. doi: 10.2319/111517-787.1 pmid: 29337631
[23]	Wang JC, Nuccion SL, Feighan JE, et al. Growth and develop-ment of the pediatric cervical spine documented radiographically[J]. J Bone Joint Surg Am, 2001, 83(8):1212-1218. pmid: 11507130
[24]	Miller CA, Hwang SJ, Cotter MM, et al. Developmental morphology of the cervical vertebrae and the emergence of sexual dimorphism in size and shape: A computed tomography study[J]. Anat Rec, 2021, 304(8):1692-1708.
[25]	Miller CA, Hwang SJ, Cotter MM, et al. Cervical vertebral body growth and emergence of sexual dimorphism: A developmental study using computed tomography[J]. J Anat, 2019, 234(6):764-777. doi: 10.1111/joa.12976 pmid: 30945292
[26]	Gray S, Bennani H, Kieser JA, et al. Morphometric analysis of cervical vertebrae in relation to mandibular growth[J]. Am J Orthod Dentofacial Orthop, 2016, 149(1):92-98.
[27]	Nestman TS, Marshall SD, Qian F, et al. Cervical vertebrae maturation method morphologic criteria: Poor reproducibility[J]. Am J Orthod Dentofacial Orthop, 2011, 140(2):182-188.
[28]	Jain S, Choudhary K, Nagi R, et al. New evolution of cone-beam computed tomography in dentistry: Combining digital technologies[J]. Imaging Sci Dent, 2019, 49(3):179-190. doi: 10.5624/isd.2019.49.3.179 pmid: 31583200
[29]	Filipp FV. Opportunities for artificial intelligence in advancing precision medicine[J]. Curr Genet Med Rep, 2019, 7(4):208-213.
[30]	Zhang AF, Sayre JW, Vachon L, et al. Racial differences in growth patterns of children assessed on the basis of bone age[J]. Radiology, 2009, 250(1):228-235. doi: 10.1148/radiol.2493080468 pmid: 18955510

名称椎体前缘高度	aVBH	简写椎体前表面上下缘中线垂直距离	定义线性长度
	椎体后缘高度	pVBH	椎体后表面上下缘中线垂直距离
	椎体上缘长度	sVBL	椎体上表面前后缘中线前后距离
	椎体下缘长度	iVBL	椎体下表面前后缘中线前后距离
	椎体上缘宽度	sVBW	椎体上表面最大横向距离
	椎体下缘宽度	iVBW	椎体下表面最大横向距离
	椎体下缘表面距离	iVBSL	椎体下表面前后缘最外侧点之间曲线长度
	横突宽度	TPW	横突最大横向距离
	棘突长度	SPL	棘突前缘至最末端距离
	左/右椎弓根高度	r/lPH	左/右侧椎弓根上下缘最外侧直径
	双侧椎弓根距离	BPD	双侧椎弓根上表面中心点距离
	左/右锥板横向长度	r/lLTL	棘突与上关节面外侧缘沿左/右锥板上缘距离
	左/右锥板高度	r/lLH	左/右锥板上下缘中线垂直距离
	左/右关节突下表面宽度	r/liAPW	左/右关节突下表面最大横向距离
平均长度	椎体前后缘高度均值	apVBH	(aVBH+pVBH)/2
	椎体上下缘长度均值	siVBL	(sVBL+iVBL)/2
	椎体上下缘宽度均值	siVBW	(sVBW+iVBW)/2
	椎弓根左右高度均值	rlPH	(rPH+lPH)/2
	锥板左右横向长度均值	rlLTL	(rLTL+lLTL)/2
	锥板左右高度均值	rlLH	(rLH+lLH) /2
	关节突左右下表面宽度均值	rliAPW	(riAPW+liAPW)/2

参数	相关系数		参数	相关系数		参数	相关系数		参数	相关系数
参数	男性	女性	参数	男性	女性	参数	男性	女性	参数	男性	女性
aVBH3	0.905^**	0.897^**	iVBW4	0.238^**	0.251^**	siVBW3	0.097	-0.148	aVBH4/iVBL4	0.810^**	0.849^**
aVBH4	0.886^**	0.885^**	TPW2	0.693^**	0.620^**	siVBW4	0.173	0.150	iVBSL2/iVBL2	0.057	0.285^**
pVBH3	0.911^**	0.880^**	TPW3	0.644^**	0.627^**	rlPH3	0.704^**	0.468^**	iVBSL3/iVBL3	0.392^**	0.258^**
pVBH4	0.872^**	0.890^**	TPW4	0.747^**	0.616^**	rlPH4	0.738^**	0.534^**	iVBSL4/iVBL4	0.216^*	-0.211^*
sVBL3	0.350^**	0.430^**	SPL2	0.659^**	0.432^**	rlLTL2	0.140	0.243^**	rlPH3×rlLH3	0.795^**	0.657^**
sVBL4	0.451^**	0.261^**	SPL3	0.543^**	0.691^**	rlLTL3	0.123	0.368^**	rlPH4×rlLH4	0.810^**	0.733^**
iVBL2	0.462^**	0.315^**	SPL4	0.351^**	0.588^**	rlLTL4	0.111	0.301^**	rlLH₂×SPL2	0.717^**	0.575^**
iVBL3	0.519^**	0.528^**	BPD3	0.485^**	0.300^**	rlLH₂	0.587^**	0.532^**	rlLH3×SPL3	0.691^**	0.750^**
iVBL4	0.566^**	0.515^**	BPD4	0.369^**	0.336^**	rlLH3	0.757^**	0.684^**	rlLH4×SPL4	0.642^**	0.705^**
sVBW3	0.007	-0.153	apVBH3	0.924^**	0.904^**	rlLH4	0.782^**	0.760^**	TPW3/siVBW3	0.447^**	0.586^**
sVBW4	0.010	0.018	apVBH4	0.908^**	0.907^**	rliAPW3	0.441^**	0.484^**	TPW4/siVBW4	0.508^**	0.377^**
iVBW2	-0.064	-0.163	siVBL3	0.458^**	0.502^**	rliAPW4	0.398^**	0.444^**	iVBL2/iVBL3	-0.304^**	-0.113
iVBW3	0.133	-0.020	siVBL4	0.527^**	0.427^**	aVBH3/iVBL3	0.860^**	0.862^**

模型	常量与自变量	偏回归系数	标准误	t	P	调整R²	方差膨胀系数
男性	常量	3.445	0.052	66.815	0.000	0.899	—
	apVBH3	1.536	0.074	20.899	0.000		2.151
	rliAPW3	-0.307	0.066	-4.673	0.000		1.679
	TPW2	0.200	0.089	2.239	0.027		3.141
	iVBW4	-0.224	0.057	-3.922	0.000		1.285
	BPD3	0.167	0.069	2.413	0.018		1.974
	iVBSL4/iVBL4	0.152	0.067	2.260	0.026		1.029
女性	常量	3.600	0.047	77.038	0.000	0.902	—
	apVBH3	0.926	0.097	9.577	0.000		4.521
	rlLH2×SPL2	0.328	0.050	6.516	0.000		1.246
	rlLTL3	0.226	0.052	4.350	0.000		1.252
	aVBH4/iVBL4	0.410	0.090	4.572	0.000		3.676
	iVBSL4/iVBL4	-0.170	0.051	-3.299	0.001		1.167
	BPD3	-0.164	0.053	-3.123	0.002		1.284

Quantitative analysis of cervical vertebral maturation in Chinese adolescents based on three-dimensional morphology of cervical vertebrae

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