Rudolf Ernst, Kramer Josef, Winkler Ingomar, Schmeling Andreas
, Wiesenstrasse 20, 4800, Attnang-Puchheim, Austria.
Institute for CT and MRT Diagnostics, Rainerstr. 6-8, 4020, Linz, Austria.
Int J Legal Med. 2019 May;133(3):931-934. doi: 10.1007/s00414-019-02025-0. Epub 2019 Feb 19.
According to the acknowledged recommendations of the multidisciplinary "Study Group on Forensic Age Diagnostics," the indicator "medial clavicular ossification" carries the potential of delivering decisive evidence to proof age majority "beyond reasonable doubt" regarding age-disputed individuals within legal procedures. Yet, sternoclavicular thin-slice computed tomography, representing its preferred imaging modality, not rarely exhibits peculiar morphologies of the site, sometimes difficult to understand from the usually obtained, axial sections together with coronal reformations. Because of that, we utilized 3D-rendering of acquired CT data in 224 cases with the purpose to gain additional visualization of certain questionable appearances. Concerning reliable classification of medial clavicular ossification in line with the typologies of Schmeling et al. and Kellinghaus et al., it is concluded that such means of illustration contribute to recognition of polygonal or irregular, epiphyseal formations including the not-assessable shape variant "multiple, medial, secondary ossification centres" and of calcification of the articular capsule.
根据多学科“法医年龄诊断研究小组”公认的建议,指标“内侧锁骨骨化”有可能在法律程序中为证明年龄有争议个体的成年年龄提供“排除合理怀疑”的决定性证据。然而,作为其首选成像方式的胸锁关节薄层计算机断层扫描,该部位的形态却并不少见,有时从通常获取的轴向截面以及冠状重建图像中很难理解。因此,我们对224例病例的CT数据进行了三维重建,目的是获得某些可疑表现的更多可视化信息。关于根据施梅林等人和凯林豪斯等人的类型对内侧锁骨骨化进行可靠分类,得出的结论是,这种图示方法有助于识别多边形或不规则的骨骺形成,包括无法评估的形状变体“多个内侧次级骨化中心”以及关节囊钙化。