Abstract: ObjectiveTo discuss the diagnostic values of CHN method，Chinese,Japanese and English standards of TW2 method，and TW3 method in skeletal age（SA）determination in children with central precocious puberty（CPP），then to comform the normal thresholds.MethodsPatient group: 61 children with complete information.Control group had 67 children:（1）61 cases were normal children,whose sex,age,height and weitht were similar to the patient group; （2）6 cases were girls whose breasts developed after 8 years old.Left handwrist Xray radiographs before therapy were retrospectively blindly analyzed by two doctors and relevant SA were assessed with CHN method，Chinese,Japanese and English standards of TW2 method，and TW3 method.The differences between SA and chronological age（CA）Δ=（SACA）were analyzed with ROC in SPSS 13.0.Results（1）The SA results showed Kappa value was 0.776 by two doctors （u=16.128，P＜0.05）.（2）Area under the curve（AUC）of ROC: ACHN= 0.921±0.024（95% confident interval: 0.875～0.967）,ATW2CHN=0.947±0.019（0.910～0.983）;ATW2JP=0.937±0.023（0.892～0.982）; ATW2Br=0.931±0.022（0.888～0.975）; ATW3=0.924±0.023（0.879～0.969）.There were no statistic differences for the AUC of ROC among the five methods（Z=0.85，P＞0.05）.（3）Δ≥1.25years in CHN,Δ≥1.25 years in TW2CHN,Δ≥0.65years in TW2JP,Δ≥1.15 years in TW2 and Δ≥0.25 years in TW3 were more sensitive and specific points.ConclusionsThe five SA determination methods provide a higher diagnostic values in children with CPP,and TW2CHN provide the hightest value for Chinese children.

Key words: Sexual maturation, Skeletal age determination；Deve lopment；Skeleton；Children