Kozan Forensic Medicine Branch Directorate, Kozan, Adana, Turkey.
Çukurova University Faculty of Medicine Department of Forensic Medicine, Sarıcam, Adana, Turkey.
Forensic Sci Int. 2023 Nov;352:111832. doi: 10.1016/j.forsciint.2023.111832. Epub 2023 Sep 18.
Forensic authorities often request age estimation from forensic experts, particularly in cases related to sexual abuse, child pornography, illegal migration, marriage, etc. The most commonly used method in this regard is radiological methods. Because of the potential dangers of radiation exposure outside of clinical indications, new researches are focusing on non-ionizing and non-invasive technologies. This study aimed to demonstrate the applicability of age estimation in living individuals from ankle magnetic resonance images as a non-ionizing method, and to determine whether it is compatible with individuals' real ages and to establish a database. Ankle MRI images of patients aged between 7 and 26 years who applied to the Cukurova University Faculty of Medicine Balcali Hospital between January 2011 and December 2020 were retrospectively evaluated. A six-stage staging method proposed by Lu et al. was applied to the distal tibial and calcaneal epiphyseal ossification points by examining ankle MRI images of a total of 331 patients, 197 males and 134 females. In the study, images obtained from a sagittal section fast spin echo T1-weighted sequence, with a section thickness of 3-4 mm, were evaluated. As a result of the study, Stage 1 in both distal tibial and calcaneal epiphysis was observed only in patients under 18 years of age in both sex. In males, stage 2 in distal tibial epiphyseal ossification was observed under 18 years of age, except for one case, and stage 5 in both distal tibial and calcaneal epiphyseal ossification was observed in almost all cases over 18 years of age in males. According to the results of our study, magnetic resonance imaging was found to be a non-ionizing method that could be used in addition to other radiological methods aimed at determining the 18-year age limit in age estimation. Multicenter, comparative, and prospective studies conducted by experienced researchers are needed to enable the routine use of MRI in age estimation.
法医学权威经常向法医专家请求年龄估计，特别是在涉及性虐待、儿童色情、非法移民、婚姻等案件中。在这方面最常用的方法是放射学方法。由于超出临床指征的辐射暴露的潜在危险，新的研究集中在非电离和非侵入性技术上。本研究旨在展示踝关节磁共振成像作为一种非电离方法在活体个体中的年龄估计适用性，并确定其是否与个体的真实年龄相兼容，并建立数据库。回顾性评估了 2011 年 1 月至 2020 年 12 月期间向库鲁瓦大学巴卡尔西医院就诊的年龄在 7 至 26 岁之间的患者的踝关节 MRI 图像。通过检查总共 331 名患者（197 名男性和 134 名女性）的踝关节 MRI 图像，应用 Lu 等人提出的六阶段分期方法对胫骨远端和跟骨骨骺骨化点进行分期。在该研究中，评估了矢状位快速自旋回波 T1 加权序列的图像，其层厚为 3-4mm。研究结果显示，在男性中，胫骨远端骨骺骨化的第 2 阶段在 18 岁以下的患者中观察到，除了一个病例外，在 18 岁以上的患者中几乎所有患者都观察到胫骨远端和跟骨骨骺骨化的第 5 阶段。根据我们的研究结果，磁共振成像被发现是一种非电离方法，可以与其他旨在确定 18 岁年龄限制的放射学方法一起用于年龄估计。需要由有经验的研究人员进行多中心、对比和前瞻性研究，以使 MRI 在年龄估计中的常规使用成为可能。
