Richard Marie-Edith, Delabarde Tania, Hmeydia Ghazi, Provost Corentin, de Jong Laura, Hamza Lilia, Meder Jean-François, Oppenheim Catherine, Ludes Bertrand, Benzakoun Joseph
Université de Paris, Paris, France.
Service de Neuroradiologie, GHU Paris Psychiatrie et Neurosciences, 1, Rue Cabanis, 75014, Paris, France.
Int J Legal Med. 2022 May;136(3):833-839. doi: 10.1007/s00414-022-02798-x. Epub 2022 Mar 1.
Age estimation is a key factor for identification procedure in forensic context. Based on anthropological findings, degenerative changes of the sternal extremity of the 4th rib are currently used for age estimation. These have been adapted to post-mortem computed tomography (PMCT). The aim of this study was to validate a post-mortem computed tomography method based on a revision of the Iscan's method on a French sample. A total of 250 PMCT (aged from 18-98 years (IQR 36-68 years, median 51 years); 68 (27%) females) from the Medicolegal Institute of Paris (MLIP) were analyzed by two radiologists. The sternal extremity of 4th right rib was scored using method adapted from Iscan et al. Weighted κ was used to evaluate intra- and inter-observer reliability and Spearman correlation was performed to evaluate relationship between age and score. Confidence intervals for individual prediction of age based on 4th rib score and sex were computed with bootstrapping. The intra-observer reliability and inter-observer reliability were almost perfect (weighted κ = 0.85 [95%CI: 0.78-0.93] and 0.82 [95%CI 0.70-0.96] respectively). We confirmed a high correlation between the 4th rib score and subject age (rho = 0.72, p < 0.001), although the confidence intervals for individual age prediction were large, spanning over several decades. This study confirms the high reliability of Iscan method applied to PMCT for age estimation, although future multimodal age prediction techniques may help reducing the span of confidence intervals for individual age estimation.Trial registration: INDS 0,509,211,020, October 2020, retrospectively registered.
年龄估计是法医鉴定程序中的一个关键因素。基于人类学研究结果，目前第四肋骨胸骨端的退行性变化被用于年龄估计。这些变化已应用于死后计算机断层扫描（PMCT）。本研究的目的是在一个法国样本上，通过对伊斯坎（Iscan）方法的修订来验证一种死后计算机断层扫描方法。来自巴黎法医学研究所（MLIP）的250例PMCT（年龄范围为18 - 98岁（四分位间距36 - 68岁，中位数51岁）；68例（27%）为女性）由两名放射科医生进行分析。采用改编自伊斯坎等人的方法对右侧第四肋骨的胸骨端进行评分。使用加权κ系数评估观察者内和观察者间的可靠性，并进行斯皮尔曼相关性分析以评估年龄与评分之间的关系。基于第四肋骨评分和性别对个体年龄预测的置信区间通过自助法计算。观察者内可靠性和观察者间可靠性几乎完美（加权κ分别为0.85 [95%置信区间：0.78 - 0.93]和0.82 [95%置信区间0.70 - 0.96]）。我们证实了第四肋骨评分与受试者年龄之间存在高度相关性（rho = 0.72，p < 0.001），尽管个体年龄预测的置信区间较大，跨越了几十年。本研究证实了应用于PMCT进行年龄估计的伊斯坎方法具有高度可靠性，尽管未来的多模态年龄预测技术可能有助于缩小个体年龄估计的置信区间跨度。试验注册：INDS 0,509,211,020，2020年10月，回顾性注册。
