Ekizoglu Oguzhan, Inci Ercan, Erdil Irem, Hocaoglu Elif, Bilgili Mustafa Gokhan, Kazimoglu Cemal, Reisoglu Ali, Can Ismail Ozgur
Department of Forensic Medicine, Tepecik Training and Research Hospital, Güney mahallesi 1140/1 Yenisehir-Konak, Izmir, Turkey.
Department of Radiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Int J Legal Med. 2016 Jul;130(4):1101-1107. doi: 10.1007/s00414-016-1345-0. Epub 2016 Feb 25.
Determination of the ossification properties of the iliac apophysis is important not only in the clinical evaluation of patients undergoing orthopedic surgery but also in age estimation studies for forensic purposes. The literature includes both anthropological and radiological (conventional radiography, ultrasonography, and magnetic resonance imaging modalities) investigations of the different staging systems used for these purposes. In this study, we assessed the utility of computed tomography (CT) of the iliac crest apophysis in estimating forensic age. CT scans of the iliac crest apophysis of 380 patients (187 females, 193 males, and 10-29 years of age) were evaluated according to the four-stage system. Further subclassification did not give data properly due to the reference length measurement of the iliac wing with CT. Thus, in our series, stage 2 was first seen in 12 years of age and stage 3 in those 14 years of age in both sexes and on both sides of the pelvis. Stage 4 was first seen in 17 years of both sexes but only on the right side; on the left side, it appeared in females 18 years of age and in males 17 years of age. Present data was found consistent with previous pelvic radiographic findings. First seen ages for stage 2 and 3 are 12 and 14 years respectively which presented valuable information for legally important age thresholds. However, disadvantages of CT, including high-dose radiation exposure to gonads, the difficulty of evaluating the iliac crest, and the age boundary of 17 years, could make this method infeasible, as compared with hand wrist and pelvic radiographic methods. CT of the iliac crest has probably a greater utility where preexisting CT scans of the pelvic region are available, and it may be considered as a supportive method for age-estimation purposes.
确定髂骨骨骺的骨化特性不仅在骨科手术患者的临床评估中很重要，而且在法医学年龄估计研究中也很重要。文献中既有关于用于这些目的的不同分期系统的人类学研究，也有放射学研究（传统放射摄影、超声检查和磁共振成像方式）。在本研究中，我们评估了髂嵴骨骺的计算机断层扫描（CT）在法医学年龄估计中的效用。根据四阶段系统对380例患者（187名女性、193名男性，年龄在10至29岁之间）的髂嵴骨骺CT扫描进行了评估。由于用CT测量髂骨翼的参考长度，进一步细分无法得到合适的数据。因此，在我们的系列研究中，两性和骨盆两侧在12岁时首次出现2期，14岁时首次出现3期。4期在两性17岁时首次出现，但仅在右侧；在左侧，女性18岁时出现，男性17岁时出现。目前的数据与先前骨盆放射学检查结果一致。2期和3期的首次出现年龄分别为12岁和14岁，这为具有法律重要性的年龄阈值提供了有价值的信息。然而，与手腕和骨盆放射学方法相比，CT的缺点包括对性腺的高剂量辐射暴露、评估髂嵴的困难以及17岁的年龄界限，这可能使该方法不可行。在已有骨盆区域CT扫描的情况下，髂嵴CT可能具有更大的效用，并且可以将其视为年龄估计目的的辅助方法。
