Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany.
Department of Medical and Industrial Image Processing, University of Applied Sciences of Wedel, Feldstraße 143, 22880, Wedel, Germany.
Eur Radiol. 2021 May;31(5):3237-3247. doi: 10.1007/s00330-020-07343-1. Epub 2020 Oct 14.
To assess epiphyseal growth plate closure of the knee for forensic age estimation using an ultrasound (US)-based method and to compare the findings with MRI.
Thirty-three healthy male individuals (age, 14.4-19.3 years) were prospectively evaluated for epiphyseal growth plate closure of the right knee by recordings of two-dimensional US volumes and a high-resolution T1-weighted MRI sequence. The degree of epiphyseal growth plate closure was rated independently by two readers for each method using a modality specific three-point scale that differentiates between an open physis (S1), a partially closed physis (S2), and a closed physis (S3).
The inter-rater agreement was high for the US (Cohen's kappa (CK): femur 95.2%, tibia 81.3%, fibula 86.3%) and the MRI method (CK: femur 70.2%, tibia 90.8%, fibula 79.8%). The degree of growth plate closure associated positively with advancing age. The US system showed a clearer separation of median ages with lower overlap than the MRI system. Open growth plates on minors (< S3 on femur and tibia) were identified by US with higher sensitivity (1.0 vs. 0.7) and slightly lower specificity (0.7 vs. 0.85) compared with MRI. The examination time was substantially shorter on US than on MRI (2.65 ± 0.91 min vs. 24.72 ± 2.72 min; p < 0.001).
The US method for evaluation of growth plate closure of the knee can reliably assign male individuals to different ossification stages and identifies minors with high accuracy. More studies with larger numbers are needed to further evaluate this method.
• US is feasible to determine the degree of epiphyseal growth plate closure of the knee, shows a high degree of reliability, and is comparable to MRI. • US of the knee can detect open growth plates on male minors with high accuracy. • US of the knee may be used as a fast, non-invasive imaging tool for forensic age estimation to identify male minors.
使用基于超声（US）的方法评估膝关节骺板闭合情况，以进行法医年龄估计，并将结果与 MRI 进行比较。
前瞻性评估 33 名健康男性个体（年龄 14.4-19.3 岁）右侧膝关节骺板闭合情况，通过二维 US 容积记录和高分辨率 T1 加权 MRI 序列进行评估。两名读者分别使用特定于模态的 3 分制对每种方法的骺板闭合程度进行独立评分，该评分区分开放骺（S1）、部分闭合骺（S2）和闭合骺（S3）。
US 的观察者间一致性很高（股骨 Cohen's kappa (CK)：95.2%，胫骨 CK：81.3%，腓骨 CK：86.3%），MRI 方法的观察者间一致性也很高（股骨 CK：70.2%，胫骨 CK：90.8%，腓骨 CK：79.8%）。骺板闭合程度与年龄呈正相关。US 系统显示出更清晰的中位数年龄分离，重叠度更低。与 MRI 相比，US 更能准确地识别未成年人（股骨和胫骨< S3）的骺板尚未闭合（敏感性 1.0 对 0.7，特异性 0.7 对 0.85）。与 MRI 相比，US 的检查时间明显更短（2.65±0.91 分钟对 24.72±2.72 分钟；p<0.001）。
用于评估膝关节骺板闭合的 US 方法可以可靠地将男性个体分配到不同的骨化阶段，并能准确识别未成年人。需要更多的研究来进一步评估这种方法。
US 可用于确定膝关节骺板闭合程度，具有高度可靠性，可与 MRI 相媲美。
US 可准确检测男性未成年人的骺板未闭。
US 可作为一种快速、无创的影像学工具，用于法医年龄估计，以识别男性未成年人。
