Forensic Imaging Unit, University Hospital of Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France.
Imaging and Radiology Department, Cornouaille Hospital of Quimper, 14 bis, avenue Yves-Thépot, 29107 Quimper cedex, France.
J Neuroradiol. 2019 Jul;46(4):248-255. doi: 10.1016/j.neurad.2018.08.003. Epub 2018 Sep 1.
To evaluate forensic identification of individuals through visual comparison of sphenoid sinus anatomical configuration using ante- and post-mortem CT-scans.
Ante- and post-mortem head CT-scan of 33 individuals were retrospectively collected. Ten head CT-scans were randomly selected from various neurological contexts and added to the ante-mortem group. Ten other head CT-scans were randomly selected from our post-mortem PACS and added to the post-mortem group. These CT-scans were assigned into 2 groups for analysis: an ante-mortem group (33 + 10) and a post-mortem group (33 + 10). For ethics and to avoid identification bias, CT-scans were anonymized - not showing any head structure but only sphenoid sinuses. An anatomical based classification system using the sphenoid sinuses anatomical variations was created according to anatomical and surgical literature. This classification was used by readers to identify in two different steps a maximum of matched and then unmatched scans.
The first reader had a sensitivity of 100% [CI: 89.4%-100%] and a specificity of 100% [CI: 99.8%-100%]. Sensitivity and specificity were respectively 93.9% [CI: 79.8%-99.3%] and 99.9% [CI: 99.6%-100%] for the second reader. Positive and negative predictive values were respectively 100% [CI: 89.4%-100%] and 100% [CI: 99.8%-100%] for the first reader. Positive and negative values were respectively 96.9% [CI: 83.8%-99.9%] and 99.9% [CI: 99.7%-100%] for the second reader. Inter-reader variability was estimated by Cohen's kappa and an excellent agreement was found.
We reported an excellent validity and reliability of subjective visual comparison of ante- and post-mortem CT-data using an anatomical based classification of the sphenoid sinus.
通过对前后 CT 扫描的蝶窦解剖结构进行视觉比较，评估对个体的法医鉴定。
回顾性收集了 33 例个体的前后头部 CT 扫描。从各种神经学背景中随机选择了 10 例头部 CT 扫描，并添加到生前组。从我们的死后 PACS 中随机选择了另外 10 例头部 CT 扫描，并添加到死后组。这些 CT 扫描被分配到 2 个分析组：生前组（33+10）和死后组（33+10）。为了符合伦理并避免识别偏见，CT 扫描被匿名化，不显示任何头部结构，只显示蝶窦。根据解剖学和外科文献，创建了一个基于蝶窦解剖变异的解剖分类系统。该分类由读者在两个不同步骤中使用，以识别最大匹配和不匹配的扫描。
第一位读者的敏感度为 100%[CI：89.4%-100%]，特异性为 100%[CI：99.8%-100%]。第二位读者的敏感度和特异性分别为 93.9%[CI：79.8%-99.3%]和 99.9%[CI：99.6%-100%]。第一位读者的阳性和阴性预测值分别为 100%[CI：89.4%-100%]和 100%[CI：99.8%-100%]。第二位读者的阳性和阴性值分别为 96.9%[CI：83.8%-99.9%]和 99.9%[CI：99.7%-100%]。通过 Cohen's kappa 估计读者间的变异性，发现具有极好的一致性。
我们报告了一种使用蝶窦解剖分类的前后 CT 数据的主观视觉比较的极好的有效性和可靠性。
