Department of Law, Institute of Legal Medicine (AgEstimation Project), University of Macerata, Macerata, Italy.
Postgraduate Program in Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB 58051900, Brazil.
Leg Med (Tokyo). 2022 Feb;54:102010. doi: 10.1016/j.legalmed.2021.102010. Epub 2021 Dec 28.
Evaluation of the ossification of the medial clavicular epiphysis plays a key role in forensic age estimation. The purpose of the present study was to assess a new numerical cut-off at the age of 18 years, taking into consideration Magnetic Resonance (MR) images of the medial clavicular epiphysis. We analyzed 163 MR scans of Italian subjects aged between 14 and 25 years. Using the data obtained we calculated two ratios: REM-1 (ratio between the length of the whole epiphysis and the length of the metaphysis) and REM-2 (ratio between the length of epiphyseal-metaphyseal fusion and the length of the metaphysis). In 68 out of 163 cases it was not possible to measure REM-2. The reproducibility was demonstrated using the Intraclass Correlation Coefficient (ICC) (Cronbach's alpha > 0.80). REM-1 and REM-2 were compared in each category of age (adult and minor) by the Wilcoxon signed-rank test. The cut-off points for measurements of REM-1 and REM-2 were determined by logistic regression. For REM-1, the cut-off scores were 0.83 for all individuals (accuracy = 94.77%) and males (accuracy = 96.05%), and 0.86 for females (accuracy = 92.30%). For REM-2, the cut-off values were 0.40 for all individuals and males (accuracy = 100.00%), and 0.41 for females (accuracy = 100.00%). Finally, receiver operating characteristic (ROC) curves for age classification based on REM-1 and REM-2 were constructed, showing that REM-2 had the highest discriminative power. Thus, a new cut-off model for predicting the age of majority has been introduced, conducting a quantitative analysis thanks to the use of a high-resolution imaging tool.
评估内侧锁骨骨骺的骨化在法医年龄估计中起着关键作用。本研究的目的是评估一个新的数值截止值 18 岁，同时考虑到内侧锁骨骨骺的磁共振（MR）图像。我们分析了 163 名年龄在 14 至 25 岁的意大利受试者的 MR 扫描。使用获得的数据，我们计算了两个比率：REM-1（整个骨骺长度与干骺端长度的比率）和 REM-2（骺-干骺端融合长度与干骺端长度的比率）。在 163 例中，有 68 例无法测量 REM-2。使用组内相关系数（ICC）（Cronbach's alpha > 0.80）证明了可重复性。通过 Wilcoxon 符号秩检验比较每个年龄组（成人和未成年人）的 REM-1 和 REM-2。通过逻辑回归确定 REM-1 和 REM-2 测量的截断值。对于 REM-1，所有个体（准确率= 94.77%）和男性（准确率= 96.05%）的截断分数为 0.83，女性为 0.86（准确率= 92.30%）。对于 REM-2，所有个体和男性（准确率= 100.00%）的截断值为 0.40，女性为 0.41（准确率= 100.00%）。最后，基于 REM-1 和 REM-2 构建了年龄分类的受试者工作特征（ROC）曲线，结果表明 REM-2 具有最高的判别能力。因此，引入了一种新的预测成年年龄的截止模型，通过使用高分辨率成像工具进行定量分析。
