West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, People's Republic of China.
Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
Int J Legal Med. 2024 Jul;138(4):1509-1521. doi: 10.1007/s00414-024-03182-7. Epub 2024 Feb 9.
Bone age assessment (BAA) is crucial in various fields, including legal proceedings, athletic competitions, and clinical medicine. However, the use of X-ray methods for age estimation without medical indication is subject to ethical debate, especially in forensic and athletic fields. The application of magnetic resonance imaging (MRI) with non-ionizing radiation can overcome this limitation in BAA. This study aimed to compare the application value of several MRI modalities of proximal humeral in BAA. A total of 468 patients with shoulder MRIs were retrospectively collected from a Chinese Han population aged 12-30 years (259 males and 209 females) for training and testing, including T weighted MRI (TWI), T weighted MRI (TWI), and Proton density weighted MRI (PDWI). Optimal regression models were established for age estimation, yielding mean absolute error (MAE) values below 2.0 years. The MAE values of TWI were the lowest, with 1.700 years in males and 1.798 years in females. The area under the curve (AUC) and accuracy values of different MRI modalities of 16-year and 18-year thresholds were all around 0.9. For the 18-year threshold, TWI outperformed TWI and PDWI. In conclusion, the three MRI modalities of the proximal humerus can serve as reliable indicators for age assessment, while the TWI performed better in age assessment and classification.
骨龄评估(BAA)在法律程序、竞技体育和临床医学等多个领域都至关重要。然而,在没有医学指征的情况下使用 X 射线方法进行年龄估计会引发伦理争议,尤其是在法医和竞技体育领域。使用无电离辐射的磁共振成像(MRI)可以克服 BAA 中的这一限制。本研究旨在比较几种肱骨头 MRI 模式在 BAA 中的应用价值。共回顾性收集了来自中国汉族人群的 468 例肩部 MRI 数据,年龄为 12-30 岁(男性 259 例,女性 209 例),用于训练和测试,包括 T 加权磁共振成像(TWI)、T 加权磁共振成像(TWI)和质子密度加权磁共振成像(PDWI)。为年龄估计建立了最佳回归模型,得到的平均绝对误差(MAE)值低于 2.0 岁。男性和女性的 TWI 的 MAE 值最低,分别为 1.700 年和 1.798 年。不同 MRI 模式的曲线下面积(AUC)和 16 岁和 18 岁阈值的准确性值均约为 0.9。对于 18 岁的阈值,TWI 优于 TWI 和 PDWI。总之,肱骨头的三种 MRI 模式可作为可靠的年龄评估指标,而 TWI 在年龄评估和分类方面表现更好。