Ekizoglu Oguzhan, Inci Ercan, Ors Suna, Hocaoglu Elif, Can Ismail Ozgur, Basa Can Doruk, Kacmaz Ismail Eralp, Kranioti Elena F
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. 2019 Jan;133(1):249-256. doi: 10.1007/s00414-018-1952-z. Epub 2018 Oct 17.
The most commonly used radiological method for age estimation of living individuals is X-ray. Computed tomography is not commonly used due to high radiation exposure, which raises ethical concerns. This problem can be solved with the use of magnetic resonance imaging (MRI), which avoids the use of ionizing radiation. The purpose of the present study was to evaluate the utility of MRI analysis of the proximal humeral epiphyses for forensic age estimations of living individuals. In this study, 395 left proximal humeral epiphyses (patient age 12-30 years) were evaluated with fast-spin-echo proton density-weighted image (FSE PD) sequences in a coronal oblique orientation on shoulder MRI images. A five-stage scoring system was used following the method of Dedouit et al. The intra- and interobserver reliabilities assessed using Cohen's kappa statistic were κ = 0.818 and κ = 0.798, respectively. According to this study, stage five first appeared at 20 and 21 years of age in males and females, respectively. These results are not directly comparable to any other published study due to the lack of MRI data on proximal humeral head development. These findings may provide valuable information for legally important age thresholds using shoulder MRI. The current study demonstrates that MRI of the proximal humerus can support forensic age estimation. Further research is needed to establish a standardized protocol that can be applied worldwide.
对于在世个体进行年龄估计时，最常用的放射学方法是X射线检查。由于辐射暴露量高，计算机断层扫描并不常用，这引发了伦理问题。使用磁共振成像（MRI）可以解决这个问题，因为它避免了使用电离辐射。本研究的目的是评估对在世个体进行法医年龄估计时，肱骨近端骨骺的MRI分析的效用。在本研究中，对395个左侧肱骨近端骨骺（患者年龄12至30岁）在肩部MRI图像上采用冠状斜位快速自旋回波质子密度加权图像（FSE PD）序列进行评估。按照德杜伊特等人的方法使用了一个五阶段评分系统。使用科恩kappa统计量评估的观察者内和观察者间可靠性分别为κ = 0.818和κ = 0.798。根据本研究，男性和女性分别在20岁和21岁首次出现第五阶段。由于缺乏关于肱骨头近端发育的MRI数据，这些结果无法与任何其他已发表的研究直接比较。这些发现可能为使用肩部MRI确定具有法律重要性的年龄阈值提供有价值的信息。当前研究表明，肱骨近端的MRI可以辅助法医年龄估计。需要进一步研究以建立一个可在全球应用的标准化方案。
