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计算机断层扫描(CT)在儿童和青少年牙齿老化中的应用。

The application of computerized tomography (CT) to the dental ageing of children and adolescents.

机构信息

Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.

出版信息

Forensic Sci Int. 2010 Feb 25;195(1-3):58-62. doi: 10.1016/j.forsciint.2009.11.011. Epub 2009 Dec 21.

Abstract

INTRODUCTION

Following a mass disaster, the aim of the Disaster Victim Identification process is to establish the identity of the victims. The ageing screening process on victims in Victoria may now be complemented with the use of computerized tomography (CT), where previously any dental ageing analysis was performed using conventional radiographs. The aim of this study was to assess the accuracy of age estimation using the dental ageing method proposed by Moorrees, Fanning and Hunt (MFH) using CT images. Intra- and inter-rater variability between two raters, one experienced and one inexperienced, was also assessed.

MATERIALS AND METHODS

The two raters were blinded to the ages of 96 deceased Australian children aged up to 15 years. Using three-dimensional (3D) shaded surface displays (SSD) and reformatted CT images, the age was first estimated based on prior experience alone, followed at a later date by the age estimation utilizing the MFH method. These estimates were then compared to the known chronological age. The results were statistically analyzed in a one-sample t-test, using the mean log-ratio of the estimated age to the chronological age.

RESULTS

Our findings show that the experienced rater was more accurate in age estimation than the less experienced when using prior experience (p<0.0001). The use of reformatted CT images to perform an ageing estimate using the MFH method was found to systematically underestimate the chronological age by 10% by both raters (p=0.784). There was no significant difference between the two raters. Intra-rater reliability was high (p=0.135).

CONCLUSIONS

CT can provide accurate estimates of dental ages. Prior experience with dental ageing and/or CT improves the accuracy. However, with the use of validated ageing charts, inexperienced raters can also achieve accurate age estimates using CT images.

摘要

简介

在大规模灾难发生后,灾难遇难者身份识别工作的目的是确定遇难者的身份。维多利亚州对遇难者的老龄化筛选过程现在可能可以补充使用计算机断层扫描(CT),而以前任何牙科老龄化分析都是使用常规射线照片进行的。本研究的目的是评估使用 Moorrees、Fanning 和 Hunt(MFH)提出的牙科年龄估测方法通过 CT 图像进行年龄估计的准确性。还评估了两位评估者(一位有经验,一位无经验)之间的组内和组间变异性。

材料和方法

两位评估者对 96 名年龄在 15 岁以下的已故澳大利亚儿童的年龄均不知情。使用三维(3D)阴影表面显示(SSD)和重新格式化的 CT 图像,首先根据先前的经验单独估计年龄,然后再使用 MFH 方法进行年龄估计。然后将这些估计与已知的实际年龄进行比较。使用样本 t 检验对结果进行统计学分析,使用估计年龄与实际年龄的对数比的平均值。

结果

我们的研究结果表明,有经验的评估者在使用先前经验进行年龄估计时比经验不足的评估者更准确(p<0.0001)。使用重新格式化的 CT 图像使用 MFH 方法进行年龄估计时,两位评估者都发现系统地低估了实际年龄 10%(p=0.784)。两位评估者之间没有显著差异。组内可靠性很高(p=0.135)。

结论

CT 可以提供准确的牙齿年龄估计。具有牙科年龄和/或 CT 经验可以提高准确性。但是,使用经过验证的年龄图表,经验不足的评估者也可以使用 CT 图像准确估计年龄。

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