TW3骨龄评分法演示
TW3骨龄评分法解释
TW3骨龄评分法解释目录1 概述 (1)2 骨龄图谱介绍 (3)3 RUS图谱说明 (4)3.1 桡骨 (4)3.2 尺骨 (5)3.3 第Ⅰ掌骨 (6)3.4 第Ⅲ、Ⅴ掌骨 (7)3.5 近端拇指股 (8)3.6 第Ⅲ、Ⅴ近端指骨 (9)3.7 第Ⅲ、Ⅴ中间指骨 (10)3.8 远端拇指骨 (11)3.9 第Ⅲ、Ⅴ远端指骨 (13)4 RUS骨龄成熟度评分 (14)1概述TW3骨龄评分法是通过X光拍左手，将Ⅹ光片根据手、腕部骨X 线征象进行的骨发育进行X线分期。
桡、尺骨远端和掌、指骨骨端的骨发育,从出现继发骨化中心、形成骨骺,到骨骺发生结构改变,最后干、骺融合,解剖形态上都经过有规律的系列变化;同样,各腕骨的发育,从出现原发性骨化中心,到完全成形,解剖形态上也都经过有规律的系列变化。
合理的X线分期和各期的专有标志是准确判断骨发育期的根本保证。
TW3的具体分期方法，其X线分期方法是将手、腕部20个骨骺的骨发育分为8或9期,即桡骨、掌骨、指骨、钩骨和大多角骨各分为9期,尺骨和7个腕骨各分为8期。
各期的顺序以英文大写字母、从A起依次表示：➢A期：骨化中心尚未出现；➢B期(萌出期)：骨化中心刚出现；➢C期(骨核期)：骨化中心的轮廓清楚;➢D期(增大期)：长骨骨骺或腕骨核增长到一定大小;➢E期、F期、G期(构形期)：长骨骨骺或腕骨核逐步成形,如关节面、骨突的形成,与邻近骨关系的变化等；➢H期（近成熟期）：若骨只分8期,则为成熟期；➢I期(成熟期)：长骨的干、骺端融合开始、完成,或腕骨核接近达到成熟形态。
2骨龄图谱介绍注释：3-桡骨，28-尺骨，19-第Ⅰ掌骨，9-第Ⅲ掌骨，14-第Ⅴ掌骨，20-近端拇指股，4-第Ⅲ近端指骨，11-第Ⅴ近端指骨，12-第Ⅲ中间指骨，23-第Ⅴ中间指骨，8-远端拇指骨，17-第Ⅲ远端指骨，21-第Ⅴ远端指骨。
3RUS图谱说明3.1桡骨说明：骨头上方是男性的分数，下方是女性的分数，如B则为男性分数为16，若为女性在为23。
高清人体骨龄鉴定图谱！（方便随时对照）
高清人体骨龄鉴定图谱！（方便随时对照）骨龄是骨骼年龄的简称，需要借助于骨骼在X光摄像中的特定图像来确定。
通常要拍摄左手手腕部位的X光片，医生通过X光片观察左手掌指骨、腕骨及桡尺骨下端的骨化中心的发育程度，来确定骨龄。
骨龄异常生物年龄（骨龄）－生活年龄的差值在±1岁以内的称为发育正常。
生物年龄（骨龄）－生活年龄的差值>1岁的称为发育提前（简称：早熟）。
生物年龄（骨龄）－生活年龄的差值<-1岁的称为发育落后（简称：晚熟）。
骨龄的异常，常常是儿科某些内分泌疾病所表现的一个方面。
许多疾病将影响骨骼发育，或使其提前或使其落后，如肾上腺皮质增生症或肿瘤、Alreb-ert综合征、性早熟、甲亢、卵巢颗粒细胞瘤等将导致骨龄提前；而卵巢发育不全（Turner综合症）、软骨发育不全、甲低等将导致骨龄明显落后。
两个概念：生活年龄、生物年龄生物年龄：通过观察骨化中心的大小、形态、结构和相互关系的变化来判断体格和生理的发育程度，通过对发育程度进行统计处理，以年龄的形式，以岁为单位进行表达的生物学年龄。
骨龄即是各年龄时的骨成熟度。
正常情况下，骨龄与实际年龄的差别应在±1岁之间，落后或超前过多即为异常。
·提前：骨龄比生活年龄大1岁以上；·延迟：骨龄比生活年龄小1岁以上；·正常：骨龄与生活年龄相差不超过1岁。
骨龄评估的临床意义：有助于儿童生长发育的监护；有助于诊断某些疾病；可用于预测成人终身高；指导内分泌临床用药。
上图中的数字为相应骨出现时的年龄女孩骨龄图谱男孩骨龄图谱骨龄评分法骨龄的测定都是利用骨的X线摄片、根据骨发育的X线征象即成熟标志而测定的。
19世纪末Boas首次提出生长速率的概念，在发现如何用X射线摄片后不久，人类生长学学者们很快将此概念和技术用于骨发育的研究，对骨龄的测定方法进行了长期探索和不断改进。
骨龄的测定方法较多，可分为计量骨化中心的“骨龄计数法”、与标准图谱比较的“骨龄图谱法”、按骨发育分期评分的“骨龄评分法”三种类型，并正在向计算机辅助评定骨龄的方向发展。
TW3骨龄评分法演示
TW3骨龄评分法演示TW3骨龄评分法演示venture capital investment guarantee mechanisms, talents, positivefor special funds, play to the guiding role of financial capital, leveraging features, evolving financial resources, capital, financial capital, protection of social capital into new patterns. 3 innovation environment, optimizing talent, create a good atmosphere. Departments at all levels to put science and technology innovation and talent working in the strategic position of priority development, and full play to the guiding role of Government, vigorously promote scientific and technological innovation and the preferential policies, mobilizing the entire society's awareness of innovation, stimulate creativity. Further open "service the green channel" for talent to provide efficient,convenient, quality service and allow all kinds of talents to focus on innovation, play to our strengths. 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County-level accreditation inrecognition of work in a timely manner, contributing to talent and rewarding scientific and technological achievements to emerge, release patent awards grants, encourage patent applications, social forces are encouraged to set up science and technology awards, create an environment conducive to scientific and technological progress, technological innovation, talent and career policy environment, rule of law, market and social environment. Comrades, technological innovation, talent is aventure capital investment guarantee mechanisms, talents, positivefor special funds, play to the guiding role of financial capital, leveraging features, evolving financial resources, capital, financial capital, protection of social capital into new patterns. 3 innovation environment, optimizing talent, create a good atmosphere. 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County-level accreditation in recognition of work in a timely manner, contributing to talent and rewarding scientific and technological achievements to emerge, release patent awards grants, encourage patent applications, social forces are encouraged to set up science and technology awards, create an environment conducive to scientific and technological progress, technological innovation, talent and career policy environment, rule of law, market and social environment. Comrades, technological innovation, talent is aventure capital investment guarantee mechanisms, talents, positivefor special funds, play to the guiding role of financial capital, leveraging features, evolving financial resources, capital, financial capital, protection of social capital into new patterns. 3 innovation environment, optimizing talent, create a good atmosphere. 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County-level accreditation inrecognition of work in a timely manner, contributing to talent and rewarding scientific and technological achievements to emerge, release patent awards grants, encourage patent applications, social forces are encouraged to set up science and technology awards, create an environment conducive to scientific and technological progress, technological innovation, talent and career policy environment, rule of law, market and social environment. Comrades, technological innovation, talent is aventure capital investment guarantee mechanisms, talents, positivefor special funds, play to the guiding role of financial capital, leveraging features, evolving financial resources, capital, financial capital, protection of social capital into new patterns. 3 innovation environment, optimizing talent, create a good atmosphere. Departments atall levels to put science and technology innovation and talent working in the strategic position of priority development, and full play to the guiding role of Government, vigorously promote scientific and technological innovation and the preferential policies, mobilizing the entire society's awareness of innovation, stimulate creativity. Further open "service the green channel" for talent to provide efficient, convenient, quality service and allow all kinds of talents to focus on innovation, play to our strengths. County-level accreditation in recognition of work in a timely manner, contributing to talent and rewarding scientific and technological achievements to emerge, release patent awards grants, encourage patent applications, social forces are encouraged to set up science and technology awards, create an environment conducive to scientific and technological progress, technological innovation, talent and career policy environment, rule of law, market and social environment. Comrades, technological innovation, talent is aventure capital investment guarantee mechanisms, talents, positivefor special funds, play to the guiding role of financial capital, leveraging features, evolving financial resources, capital, financial capital, protection of social capital into new patterns. 3 innovation environment, optimizing talent, create a good atmosphere. Departments at all levels to put science and technology innovation and talent workingin the strategic position of priority development, and full play to the guiding role of Government, vigorously promote scientific and technological innovation and the preferential policies, mobilizing the entire society's awareness of innovation, stimulate creativity. Further open "service the green channel" for talent to provide efficient, convenient, quality service and allow all kinds of talents to focus on innovation, play to our strengths. County-level accreditation inrecognition of work in a timely manner, contributing to talent and rewarding scientific and technological achievements to emerge, release patent awards grants, encourage patent applications, social forces are encouraged to set up science and technology awards, create an environment conducive to scientific and technological progress, technological innovation, talent and career policy environment, rule of law, market and social environment. Comrades, technological innovation, talent is aventure capital investment guarantee mechanisms, talents, positivefor special funds, play to the guiding role of financial capital, leveraging features, evolving financial resources, capital, financial capital, protection of social capital into new patterns. 3 innovation environment, optimizing talent, create a good atmosphere. Departments atall levels to put science and technology innovation and talent working in the strategic position of priority development, and full play to the guiding role of Government, vigorously promote scientific and technological innovation and the preferential policies, mobilizing the entire society's awareness of innovation, stimulate creativity. Further open "service the green channel" for talent to provide efficient, convenient, quality service and allow all kinds of talents to focus on innovation, play to our strengths. County-level accreditation in recognition of work in a timely manner, contributing to talent and rewarding scientific and technological achievements to emerge, release patent awards grants, encourage patent applications, social forces are encouraged to set up science and technology awards, create an environment conducive to scientific and technological progress, technological innovation, talent and career policy environment, rule of law, market and social environment. Comrades, technological innovation, talent is a。
tw3骨龄评分法
tw3骨龄评分法
TW3骨龄评分法是一种通过观察和评估骨骼发育程度来确定个体骨龄的方法。
具体来说，TW3评分法将手、腕部20个骨骺的骨发育分为8或9期，即桡骨、掌骨、指骨、钩骨和大多角骨各分为9期，尺骨和7个腕骨各分为8期。
各期的顺序以英文大写字母、从A 起依次表示：A期：骨化中心尚未出现；B期：( 萌出期)骨化中心刚出现；C期：(骨核期)骨化中心的轮廓清楚；D期：(增大期)长骨骨骺或腕骨核增长到一定大小；E期、F期、G期：(构形期)长骨骨骺或腕骨核逐步成形，如关节面、骨突的形成，与邻近骨关系的变化等；H期：(近成熟期；若骨只分8期，则为成熟期)、I期(成熟期)长骨的干、骺端融合开始、完成，或腕骨核接近、达到成熟形态。
TW3评分法的优势在于准确度高，尤其是在孩子身高、体重存在异常的情况下，能提供较为全面和针对性的评估。
然而，这种方法也存在一些缺点，如耗费的时间较长，通常需要医生进行计算和评估。
因此，在临床实践中，医生可能会根据具体情况选择其他更快速或更简便的评估方法。
以上信息仅供参考，如有需要，建议咨询专业医生。
(参考课件)骨龄评定和身高预测
男孩
女孩
BA Ht %
BA
Ht %
BA
Ht %
BA
Ht %
3 △56.7
11 △84.6 □ 80.4 3 △60.0
10 △87.5 □ 86.2
3½ 4 60.8
11½ 12½
88.0
81.8 85.3
3½ 4
62.1 64.3
11 91.7 12 90.6
4½ 5 64.8
13 93.3 87.6 42/12 66.5
△ BA = CA者较合适 △ 原表有BA > CA 和 BA < CA的应用数
据
10
预测成人期终身高（ PAH ）
实测身高 =
当前骨龄（ G - P）的身高百分率
11
应用 B - P预测身高的原则， 可以根据95年我国普查所得 资料计算出我国儿童按骨龄 的身高增长百分率。
12
身高增长百分率表
桡、尺骨： 尺骨骨骺初现，桡骨骨骺的尺骨端增大。
5
女 7岁10月
指骨： 2、3近端指骨干的远端略凹，拇指远端 指骨骨骺关节面变平，2 ~ 5远端指骨骨 骺成形以适应中间指骨远端的关节面。
掌骨： 第2掌骨基底变凹，其头骨面延伸。
腕骨： 三角骨的月骨面更平，月骨已形成头、 桡骨的关节面，舟骨的头骨面的掌面缘可 见，大多角骨与第1、2掌骨近端的相邻面 呈圆形隆起，而与第1掌骨相邻的中间部分 则凹入，大多角骨部分与小多角骨外侧缘 重叠，小多角骨的舟骨面变平，可见到其背、 掌面缘。
3
摄 片 要 求：
1. 左手正位； 手背向球管； 手、腕、掌、 中指、肘在同一水平轴位；手指适当 分开。
2. 球管离手74 cm； 以第三中指骨骺为 中心。
tw3骨龄评分法
tw3骨龄评分法摘要：1.骨龄评分法简介2.TW3 骨龄评分法的原理3.TW3 骨龄评分法的应用4.TW3 骨龄评分法的优势与局限5.结论正文：骨龄评分法是一种通过X 光检查手腕部骨骼发育情况，来评估个体年龄的方法。
TW3 骨龄评分法是一种常见的骨龄评估方法，它通过对手腕部骨骼的形态、大小、成熟程度等因素进行评分，最终得出一个骨龄值。
这个骨龄值可以用于评估个体的生长发育情况，预测其未来身高，以及判断某些疾病的发生概率等。
TW3 骨龄评分法的原理是通过对手腕部骨骼的不同部位（如手腕骨、掌骨、指骨等）进行形态学观察和测量，根据其发育程度来确定骨龄。
具体来说，评分者会根据骨骼的形态、大小、成熟程度等特征，给予相应的得分，然后将这些得分加总，得出一个骨龄值。
这个骨龄值与实际年龄相比，可以反映出个体的生长发育情况。
TW3 骨龄评分法广泛应用于医学、法医学、体育等领域。
在医学领域，它可以帮助医生评估患者的生长发育情况，预测其未来身高，以及判断某些疾病的发生概率。
在法医学领域，它可以帮助鉴定人员确定尸体的年龄，为案件侦破提供线索。
在体育领域，它可以帮助教练员评估运动员的生长发育情况，制定合适的训练计划。
TW3 骨龄评分法具有操作简便、结果可靠等优势，但也存在一些局限。
首先，它需要专业人员进行评分，因此准确性受到评分者经验的影响。
其次，它对手腕部骨骼的发育情况有较高的要求，如果骨骼发育不良，可能会影响评分结果的准确性。
最后，它无法评估个体的生长潜力，因此不能完全预测其未来身高。
总的来说，TW3 骨龄评分法是一种实用的评估个体年龄的方法，它可以帮助我们了解个体的生长发育情况，为医学、法医学、体育等领域提供有价值的信息。
tw3骨龄评分法
tw3骨龄评分法TW3骨龄评分法是一种常用于评估儿童骨龄的方法，它能够通过X 光检查，根据儿童手腕和手指的骨骺发育情况，来确定儿童的生长和发育水平。
本文将介绍TW3骨龄评分法的原理和应用，并探讨其在临床实践中的重要性和意义。
一、TW3骨龄评分法的原理TW3骨龄评分法是由著名的骨龄评估专家Gruelich和Pyle于1959年提出的。
该方法主要依据儿童骨骼的发育情况，将手腕和手指的骨骺与一系列参考图像进行比较，从而判断儿童的骨龄。
这些参考图像是基于正常儿童的骨骼发育过程进行拍摄和分类的。
二、TW3骨龄评分法的应用TW3骨龄评分法广泛应用于儿科临床实践和科学研究中，它可以对儿童进行生长发育情况的评估，包括评估生长迟缓、提前发育等问题。
通过测量骨龄，医生可以及时发现儿童的生长异常情况，并采取相应的干预措施，以促进其健康发育。
三、TW3骨龄评分法的操作步骤1. 选择适当的X光片：通常选择腕关节正位片和手关节斜位片，以清晰显示骨骺的发育情况。
2. 确定手腕和手指的骨骺区域：根据参考图像，确定手腕和手指的骨骺生长区域。
3. 比较骨骺与参考图像：将所测量的骨骺与参考图像进行比较，找到对应的骨骼发育阶段。
4. 判断骨龄：根据所得到的骨骼发育阶段，确定儿童的骨龄。
四、TW3骨龄评分法的临床意义TW3骨龄评分法具有以下几个临床意义：1. 评估生长发育异常：通过骨龄评估，医生可以判断儿童的生长发育是否异常，及时发现和处理生长迟缓、提前发育等问题。
2. 制定个体化治疗方案：根据骨龄评估结果，医生可以制定针对性的个体化治疗方案，避免一刀切的治疗方式，提高治疗效果。
3. 观察生长变化趋势：通过连续的骨龄评估，可以观察儿童的生长变化趋势，及时调整治疗方案，预测儿童未来的生长潜力。
4. 研究发育生物学：TW3骨龄评分法的应用也在儿童生长发育的科学研究中发挥了重要作用，为研究发育生物学提供了重要的数据。
五、总结TW3骨龄评分法作为一种常用的骨龄评估方法，在儿科临床实践和科学研究中具有重要的应用价值。
医院儿科培训PPT骨龄评估与成年身高预测
TW2、TW3、CHN 骨 龄 评 估 部 位
❖ 手、腕骨
❖
❖ 橈骨 ❖ 尺骨
❖ 掌骨 1、3、5
❖ 近指骨 1、3、5 ❖ 中指骨 3、5 ❖ 远指骨 1、3、5
❖ 腕骨 除豆骨
❖ 共计 （块）
❖
RUS系 C系 T系 CHN (TW2,TW3) (TW2)
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
7块 7块 头,钩
46 m 192 m
近节指 1 2 3 -5
中节指 2 3 -4 5
远节指 1 2 -5
42 m 47 m 48 m x 3 42 m 46 m x 2 39 m 45 m 48 m x 4
42 m 47 m 144 m 42 m 92 m 39 m 45 m 192 m
共计 26 块
1245 m
1245 / 26 = 48 m = 4 岁 （BA)
13
7
20 14
G -P
发表 1962 1975
1991
2001
1995
1950
对象 英,中层 英,中下 2600名 2702名
长沙,中 2122名
欧,北美,中 6省市 美,上 层 22160名 6879BA片
方法 横
纵+横
横
纵+横
横
纵
特点 20块骨 同前
同前
同前
14块骨 29块骨
tw3骨龄评分法对照表
tw3骨龄评分法对照表一、骨龄评分法简介骨龄评分法是一种通过评估骨骼发育的成熟度来预测生物年龄的方法。
它通常用于评估儿童的生长发育状况，以及协助诊断一些与生长发育相关的疾病。
TW3骨龄评分法是其中一种常用的评分方法，被广泛应用于临床实践和研究。
二、骨龄评分对照表TW3骨龄评分法将骨骼发育分为若干阶段，每个阶段都有相应的评分。
以下是TW3骨龄评分对照表：1.手腕骨化中心出现之前：0分2.手腕骨化中心出现：1分3.手腕骨化中心成熟：2分4.指骨发育相当于12岁：2分5.指骨发育相当于13岁：3分6.指骨发育相当于14岁：4分7.指骨发育相当于15岁：5分8.指骨发育相当于16岁：6分9.指骨发育相当于17岁：7分10.指骨发育相当于18岁：8分三、骨龄评分方法骨龄评分方法是根据被评估者的手腕和指骨发育状况，参照TW3骨龄评分对照表，对被评估者的骨骼发育进行评分。
具体步骤如下：1.观察被评估者的手腕X光片，识别出各个骨化中心的出现和成熟情况；2.观察被评估者的手指X光片，记录下每个指骨的发育程度；3.根据TW3骨龄评分对照表，将被评估者的骨骼发育状况与标准进行比较，得出相应的评分。
四、对照表的解读和使用TW3骨龄评分对照表提供了不同年龄段骨骼发育的参考标准，通过比较被评估者的骨骼发育状况与标准，可以得出被评估者的生物年龄。
在临床实践中，医生可以根据TW3骨龄评分结果判断儿童的生长发育状况，协助诊断一些与生长发育相关的疾病，如生长激素缺乏症、性早熟等。
此外，TW3骨龄评分结果还可以用于评估治疗效果和预测成年身高。
五、注意事项在使用TW3骨龄评分法时，需要注意以下几点：1.骨骼发育状况会受到遗传、营养、生活环境等多种因素的影响，因此在使用TW3骨龄评分法时需要综合考虑个体差异；2.TW3骨龄评分法只是一种参考方法，不能替代全面的生长发育评估；3.在进行手腕和手指X光检查时，需要注意保护儿童的身体健康，避免不必要的辐射暴露；4.对于一些特殊情况，如手部畸形、创伤等，可能会影响TW3骨龄评分的准确性。
tw3骨龄评分法
tw3骨龄评分法TW3骨龄评分法（Tanner-Whitehouse method 3）是一种常用于评估儿童生长发育的方法。
通过对儿童的手腕和手指骨骼的成熟度进行评估，可以确定儿童的骨龄，从而了解其生长发育状况。
下面将介绍TW3骨龄评分法的原理和应用。
一、原理及发展历程TW3骨龄评分法最早由英国人Tanner和Whitehouse于1975年提出，是Tanner提出的评估儿童青春期发育的方法的改良版。
该方法通过对儿童手腕和手指骨骼的成熟度进行评估，根据不同年龄的儿童所具备的骨骼特征，对其进行骨龄评分。
二、评估流程1. 收集手腕X射线片：评估者需要收集儿童的手腕X射线片，这些片子必须清晰可见，并且能够清楚显示骨骼的结构及发育程度。
2. 选择评分指标：根据图谱中的指标，人工选择与儿童手腕尺寸最接近的参考标准，并进行比较。
3. 进行骨龄评分：根据指定的评分标准，对儿童的手腕和手指骨骼进行评分，包括骨龄标志物的出现、愈合程度、骨骼密度等。
通过将各项评分加总，得出儿童的骨龄。
4. 结果分析：根据评分结果，与正常儿童骨龄发育曲线进行比较，判断儿童骨龄的发育状态。
三、应用价值1. 评估生长发育：TW3骨龄评分法可以有效评估儿童的生长发育情况，从而为儿科医生提供指导，并及时发现发育异常或生长激素缺乏等问题。
2. 判断青春期发育：通过TW3骨龄评分法，医生可以评估青春期的发育情况，判断是否存在早或迟发育的情况，以便及时采取相应的治疗措施。
3. 评估疾病进展：TW3骨龄评分法可以用于评估某些疾病的进展情况，如骨折的愈合程度、骨质疏松等，为治疗提供参考。
4. 研究儿童生长规律：通过收集大量儿童骨龄数据，可以对儿童的生长规律进行研究，为儿科医学的发展提供依据。
四、优缺点1. 优点：TW3骨龄评分法评估结果具有客观性和准确性，能够反映儿童的骨骼发育水平，成熟度评估较为全面。
2. 缺点：TW3骨龄评分法需要获取儿童手腕X射线片，受到辐射影响，存在一定的危险性。
tw3骨龄评分法
tw3骨龄评分法
一、概述TW3 骨龄评分法
TW3 骨龄评分法是一种评估骨骼发育程度的方法，主要用于评估儿童的生长发育状况。
该方法由法国科学家Thomas和Wilson于1987年首次提出，现已成为全球范围内骨龄评估的常用方法。
二、TW3 骨龄评分法的原理与步骤
TW3 骨龄评分法基于手腕X线片，通过对手腕关节的各个骨骺线进行分析，评估骨骼的发育程度。
具体步骤包括：拍摄手腕X线片、观察骨龄指标、对骨龄指标进行评分、计算总分、判断骨龄。
三、TW3 骨龄评分法的应用领域
TW3 骨龄评分法广泛应用于儿科、内分泌科、生长发育科等领域，对于诊断生长发育异常、评估营养状况、监测儿童生长发育具有重要意义。
四、TW3 骨龄评分法的优点与局限性
TW3 骨龄评分法的优点在于：标准化程度高、评估结果可靠、操作简便、适用于不同年龄段。
然而，该方法也存在局限性，如：对放射线有一定辐射、对读片技术要求较高、受评估者个体差异影响等。
五、我国在TW3 骨龄评分法的应用与发展
我国在TW3 骨龄评分法的应用方面，已经积累了丰富的经验。
研究人员在实践中不断改进和优化评分方法，如：引入我国儿童手腕X线片数据库、制定适合我国儿童的TW3 骨龄评分标准、开发相关软件等。
同时，我国还在探索将TW3 骨龄评分法与其他评估方法相结合，以提高评估的准确性。
综上，TW3 骨龄评分法作为一种评估骨骼发育程度的重要方法，在我国得到了广泛的应用和发展。
骨龄评测方法PPT课件
初潮与骨龄时间关系密切，初潮骨龄平均13y （12.5y-14y）
骨龄与青春期身高突增关系
身高突增（PHV）是青春期发育重要标志 PHV骨龄分布 男性 14.0±0.8 女性 12.0±0.7
骨龄与身体成熟程度关系（二）
骨龄与第二性征发育关系
第二性征的出现是青春发育的重要标志 骨龄比实际年龄更加密切
大多角骨远端明显向第2掌骨基底突起 “头钩三角月舟大小豆” 每一个骨的发育过程具有连续性和阶段性；
掌骨共5块，由桡侧向尺侧，分别称为第1-5掌骨。 “头钩三角月舟大小豆” 初潮与骨龄时间关系密切，初潮骨龄平均13y（12. 骨龄评测方法- - G-P图谱法 初潮与骨龄时间关系密切，初潮骨龄平均13y（12. 骨发育水平介于两张标准图谱之间，可用最接近一张为准
反映身体的一个发育程度，诸骨的总发育程度 才反映身体的总成熟程度
骨龄评估的临床意义
有助于儿童生长发育的监测 有助于诊断某些疾病 可用于预测成人终身高 指导内分泌临床用药
4,5近端指骨骨骺开始变凹
舟骨和小多角骨骨化中心 出现
女性 4岁2个月
骨骺与其相应的骨干骺端等宽
三角骨的掌侧可见豌 豆骨的骨化中心
女性 8岁10个月
骨骺均已盖住骨干，以桡 侧为明显
第一掌骨头出 现籽骨
桡骨骨骺与干骺端相吻合
女性 11岁
远端拇指干骺端开始融合
第一掌骨骨骺已盖住干端，第二 掌骨基底已盖住小多角骨
女性13岁
指骨骨骺约等于 骨干宽度的三分 之二
骨骺宽度大于干骺 端二分之一
男性 5 岁
第2，3近端指骨远端稍凹陷
大多角骨远端明显 向第2掌骨基底突起
骨龄评测方法- - G-P图谱法
TW骨龄评分法解释
T W骨龄评分法解释集团企业公司编码：（LL3698-KKI1269-TM2483-LUI12689-ITT289-T W3骨龄评分法解释目录1概述TW3骨龄评分法是通过X光拍左手，将Ⅹ光片根据手、腕部骨X线征象进行的骨发育进行X线分期。
桡、尺骨远端和掌、指骨骨端的骨发育,从出现继发骨化中心、形成骨骺,到骨骺发生结构改变,最后干、骺融合,解剖形态上都经过有规律的系列变化;同样,各腕骨的发育,从出现原发性骨化中心,到完全成形,解剖形态上也都经过有规律的系列变化。
合理的X线分期和各期的专有标志是准确判断骨发育期的根本保证。
TW3的具体分期方法，其X线分期方法是将手、腕部20个骨骺的骨发育分为8或9期,即桡骨、掌骨、指骨、钩骨和大多角骨各分为9期,尺骨和7个腕骨各分为8期。
各期的顺序以英文大写字母、从A起依次表示：A期：骨化中心尚未出现；B期(萌出期)：骨化中心刚出现；C期(骨核期)：骨化中心的轮廓清楚;D期(增大期)：长骨骨骺或腕骨核增长到一定大小;E期、F期、G期(构形期)：长骨骨骺或腕骨核逐步成形,如关节面、骨突的形成,与邻近骨关系的变化等；H期（近成熟期）：若骨只分8期,则为成熟期；I期(成熟期)：长骨的干、骺端融合开始、完成,或腕骨核接近达到成熟形态。
2骨龄图谱介绍注释：3-桡骨，28-尺骨，19-第Ⅰ掌骨，9-第Ⅲ掌骨，14-第Ⅴ掌骨，20-近端拇指股，4-第Ⅲ近端指骨，11-第Ⅴ近端指骨，12-第Ⅲ中间指骨，23-第Ⅴ中间指骨，8-远端拇指骨，17-第Ⅲ远端指骨，21-第Ⅴ远端指骨。
3RUS图谱说明3.1桡骨说明：骨头上方是男性的分数，下方是女性的分数，如B则为男性分数为16，若为女性在为23。
上图具体特征为：B期:骨化中心初现,为一或数个小钙化点,边缘不清晰。
C期:骨化中心呈椭圆形,边缘清晰、光滑、连续。
D期:①骨化中心直径≥1/2干骺端宽度；②骨骺桡侧增厚,较圆,尺侧呈椎状；③近侧面变平,稍增厚,与桡骨骺端的问距变小,约为Im。
TW3骨龄评分法解释
TW3骨龄评分法解释目录1概述TW3骨龄评分法是通过X光拍左手，将Ⅹ光片根据手、腕部骨X 线征象进行的骨发育进行X线分期。
桡、尺骨远端和掌、指骨骨端的骨发育,从出现继发骨化中心、形成骨骺,到骨骺发生结构改变,最后干、骺融合,解剖形态上都经过有规律的系列变化;同样,各腕骨的发育,从出现原发性骨化中心,到完全成形,解剖形态上也都经过有规律的系列变化。
合理的X线分期和各期的专有标志是准确判断骨发育期的根本保证。
TW3的具体分期方法，其X线分期方法是将手、腕部20个骨骺的骨发育分为8或9期,即桡骨、掌骨、指骨、钩骨和大多角骨各分为9期,尺骨和7个腕骨各分为8期。
各期的顺序以英文大写字母、从A起依次表示：➢A期：骨化中心尚未出现；➢B期(萌出期)：骨化中心刚出现；➢C期(骨核期)：骨化中心的轮廓清楚;➢D期(增大期)：长骨骨骺或腕骨核增长到一定大小;➢E期、F期、G期(构形期)：长骨骨骺或腕骨核逐步成形,如关节面、骨突的形成,与邻近骨关系的变化等；➢H期（近成熟期）：若骨只分8期,则为成熟期；➢I期(成熟期)：长骨的干、骺端融合开始、完成,或腕骨核接近达到成熟形态。
2骨龄图谱介绍注释：3-桡骨，28-尺骨，19-第Ⅰ掌骨，9-第Ⅲ掌骨，14-第Ⅴ掌骨，20-近端拇指股，4-第Ⅲ近端指骨，11-第Ⅴ近端指骨，12-第Ⅲ中间指骨，23-第Ⅴ中间指骨，8-远端拇指骨，17-第Ⅲ远端指骨，21-第Ⅴ远端指骨。
3RUS图谱说明3.1桡骨说明：骨头上方是男性的分数，下方是女性的分数，如B则为男性分数为16，若为女性在为23。
上图具体特征为：B期:骨化中心初现,为一或数个小钙化点,边缘不清晰。
C期:骨化中心呈椭圆形,边缘清晰、光滑、连续。
D期:①骨化中心直径≥1/2干骺端宽度；②骨骺桡侧增厚,较圆,尺侧呈椎状；③近侧面变平,稍增厚,与桡骨骺端的问距变小,约为Im。
E期:骨骺远端边缘的内侧出现一增粗的白线,为其掌面的边缘,在其外侧即为其背侧面的边缭。