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1.
To improve the accuracy of forensic age estimation where there is no legal basis for carrying out x-ray examinations, it would be useful to establish non-x-ray imaging techniques. The objective of this study was to provide reference data for the magnetic resonance imaging-based evaluation of the ossification stage of the distal radius. Furthermore, we tested a new criterion of the maturity of the distal radial epiphysis for determining whether an individual has completed the age of 18. We investigated 668 MRI scans of the distal radial epiphysis from 333 female and 335 male subjects ranging in age from 12 to 24. To determine the ossification stage, we used the clavicular ossification staging systems described by Schmeling et al. and Kellinghaus et al. Ossification stage IV as described by Schmeling et al. was divided into two sub-stages, IVa and IVb, depending on whether or not it was possible to identify a triple-banded meta-epiphyseal zone of calcification. All study subjects were able to be assigned to an ossification stage without ambiguity. We present statistics relating to the distribution of ossification stages divided by sex. The age of the youngest female subject assessed as ossification stage IVb was 16.8, the age of the youngest male subject 18.6. The youngest age at which female subjects were assessed as ossification stage V was 22.3; for male subjects it was 23.1. Further independent studies should be carried out to determine whether ossification stage IVb can indeed be used to reliably determine whether a male subject has completed the age of 18. 相似文献
2.
Skeletal maturity is evaluated by many radiological methods for forensic age estimation. Direct radiography and computed tomography lead to a rise in ethical concerns due to radiation exposure. Therefore, magnetic resonance imaging (MRI) has currently been used in recent studies. In this study, the ossification stage of the shoulder joint was determined retrospectively in 178 male and 109 female individuals in the age group 12 to 30 years using 3.0 T MRI. All the images were evaluated with T1-weighted turbo spin echo (T1 TSE) sequence and T1 fast low angle shot two-dimensional sequence (T1 FL2D). The combined staging method, which was defined by Kellinghaus et al. and Schmeling et al., was used. The intra- and inter-observer agreement levels were very good (κ and κ w). There were no significant age differences between males and females in all stages. In most of the stages, the ossification of the proximal humeral epiphyses occurred earlier in females than in males. Stage 4 did not occur in either of the sexes before the 18th birthday as the youngest patients in this stage was at 19 and 18 years of age in males and females, respectively. We concluded that evaluating the ossification of the proximal humeral epiphysis with MRI imaging for forensic age estimation may be beneficial. Evaluating the same anatomical structure with different MRI sequences may be useful for accurate staging diagnosis. 相似文献
3.
To increase the reliability of forensic age estimations in living adolescents and young adults where there is no legitimation for X-ray examinations, it would be desirable to establish radiation-free imaging methods. In the present study, the ossification stage of the distal femoral epiphysis was determined retrospectively in 166 male and 124 female individuals in the age group 10 to 30 years using 3.0T MRI. When evaluating the ossification stage, a combination of the classifications proposed by Schmeling et al. and by Kellinghaus et al. was used. Within the study population, stages 3b, 3c and 4 did not occur in the male sex before the 14th birthday, although the validity of the results is distinctly limited relative to stage 3b in view of the small number of cases. In females, stages 3c and 4 did not occur before the 14th birthday. Stage 4 did not occur in males before the 18th birthday. Should this result be confirmed in future studies, there would be an additional criterion providing evidence that the age of 18 years has been completed. 相似文献
4.
There is an increasing demand for age estimations of living persons who are involved in civil and criminal procedures but lack a valid birth certificate indicating their date of birth. Several studies have recommended the application of magnetic resonance imaging (MRI) and assessment of the stage of epiphyseal fusion in age estimation. This study involved retrospective MRI analysis of 335 cases (217 males and 118 females) whose ages ranged from 8 to 28 years (yrs). We assessed the degree of ossification of the proximal tibial epiphysis depending on the classifications of Schmeling and Kellinghaus used for the main stages (I, II, III, IV & V) and substages (IIa, b, c & IIIa, b, c). Significant differences between males and females at stages IIIc, IV and V (p < 0.001) were observed. Additionally, the ossification of the proximal tibial epiphyses occurred earlier in females than in males (2–4 yrs). The mean of ages in stage IV was approximately 18.6 yrs. in females and 22.5 yrs. in males, meaning that stage IV can be used as a valuable forensic marker to determine whether the person in question has reached the age of 18 yrs. We concluded that the application of MRI in the assessment of the ossification status of the proximal tibial epiphysis could be helpful in age estimation for various forensic purposes. 相似文献
5.
Thin-slice computed tomography provides the imaging modality of choice in analysing the ossification process of the medial clavicular epiphysis for the purpose of forensic age diagnostics in the living in the course of criminal proceedings. The classification of the ossification stages by Schmeling et al. compass the emergence of an epiphyseal ossification centre (stage 2), the partial fusion of the epiphysis with the metaphysis (stage 3), the complete fusion of these osseous elements including a visible epiphyseal scar (stage 4), and the complete fusion without a visible epiphyseal scar (stage 5). In the present study, each of the ossification stages 2 and 3 was divided into an early, intermediate and late phase. The authors evaluated the thin-slice CT scans of 185 patients aged between 13 and 26 years. In all these cases, a stage 2 or 3 had been determined in a previous study. The late stage 3, which is characterized by a fusion between metaphysis and epiphysis completing more than two thirds of the former epiphyseal gap, first appeared at age 19 in both sexes. If a late stage 3 is found, it is therefore possible to substantiate that an individual has already reached the legally important age threshold of 18 years. 相似文献
6.
Background Despite a relatively minimal level of radiation exposure, the use of x-ray radiation for the forensic estimation of chronological age of individuals is often subject to public criticism. In the recent past this has encouraged the scientific investigation of alternative imaging procedures with which the radiation-free assessment of the skeletal maturation process is possible. Aim The present study investigated the applicability of ultrasound diagnostics for assessing the ossification processes of the epiphysis of the greater trochanter. Material and methods For this purpose the epiphyseal ossification stages of 307 female and 309 male test persons between 10 and 25 years of age were determined. Results In the female subjects ossification stage II was found at the earliest at 10.1 years (x??=?12.2 years), ossification stage III at the earliest at 12.5 years (x??=?15.1 years) and ossification stage IV at the earliest at 13.4 years (x??=?20.8 years). In the male subjects ossification stage II was observed from 10.0 years (x??=?12.8 years), ossification stage III from 13.8 years (x??=?16.0 years) and ossification stage IV from 14.5 years (x??=?21.3 years). Conclusion With the legal basis as it stands at present, the sonographic examination of the femoral trochanter epiphysis allows individual radiation exposure to be kept to a minimum in the use of x-rays on humans in the forensic age estimation practice of living individuals. In areas of application where there is no legal authorization basis for radiological examinations, including a skeletal maturity criterion can increase the accuracy and reliability of age estimation. 相似文献
7.
ObjectivesTo assess the performance of knee MRI for forensic age prediction and classification for 12-, 14-, 16-, and 18-year thresholds. MethodsThe ossification stages of distal femoral epiphyses and proximal tibial epiphyses were assessed using an integrated staging system by Schmeling et al. and Kellinghaus et al. for knee 3.0T MRI with T1-weighted turbo spin-echo (T1-TSE) in sagittal orientation among 852 Chinese Han individuals (483 males and 369 females) aged 7–30 years. Regression models for age prediction were constructed and their performances were evaluated based on mean absolute deviation (MAD) values. In addition, the performances of age classification were assessed using receiver operating characteristic (ROC) analyses. ResultsThe intra- and inter-observer agreement levels were very good (κ > 0.80). The complete fusion of those two types of epiphyses took place before 18.0 years in our study participants. The minimum MAD values were 2.51 years (distal femur) and 2.69 years (proximal tibia) in males, and 2.75 years (distal femur) and 2.87 years (proximal tibia) in females. The specificity values of constructed prediction models were all above 90% for the 12-, 14-, and 16-year thresholds, compared to the 74.8–84.6% for the 18-year threshold. Better performances of age prediction and classification were observed in males by distal femoral epiphyses. ConclusionsOssification stages via 3.0T MRI of the knee with T1-TSE sequence using an integrated staging system could be a reliable noninvasive method for age prediction or for age classification for 12-, 14-, and 16-year thresholds, especially in males by distal femoral epiphyses. However, assessments based on the full bony fusion of the distal femoral epiphysis and proximal tibial epiphysis seemed not reliable for age classification for the 18-year threshold in the Chinese Han population. 相似文献
8.
By determining the ossification stage of the distal radial epiphysis, it is possible to gain important information to help clarify the question of whether various legally relevant age limits have been exceeded. Any examination of the hand by means of projection radiography such as that used in conventional skeletal age diagnostics is strictly regulated for reasons of radiation hygiene. In many areas of the law, there are no basic legal provisions authorising the performance of X-ray examinations. The present study examines the applicability of ultrasound diagnostics in assessing ossification processes in the distal radius. To this end, the ossification stages of the distal radial epiphysis were determined in 306 female and 309 male study participants aged between 10 and 25 years. In the female gender, ossification stage III was determined at an age of 13.4 years at the earliest, and ossification stage IV at 15.0 years at the earliest. In the male gender, ossification stage III was not observed until 14.3 years, and ossification stage IV not until 15.2 years. In the practice of forensic age estimation in living persons, sonographic examination of the distal radius in areas of application with no legal basis for authorising X-ray examinations makes it possible to improve the accuracy of age diagnosis by including criteria of skeletal maturation. In view of the existing legislative basis for the use of X-rays on human subjects, the exposure of individuals to radiation can be minimised. 相似文献
9.
The authors retrospectively analyzed 629 CT images of patients aged between 15 and 30 years produced during multiple trauma diagnostics at the Unfallkrankenhaus Berlin. For the purposes of this study, the authors reliably determined the ossification status of the medial epiphysis of the clavicle in 556 cases, using the classification of stages by Schmeling et al. In both sexes, stage 2 was first noted at age 15. In male patients, the earliest occurrence of stage 3 was noted at age 17, in female patients at age 16. Stage 4 was first achieved by both sexes at age 21. Stage 5 was first noted in female patients at age 21 and in male patients at age 22, which is 4 or 5 years earlier than was observed by a comparable study using conventional radiographs. The partial-volume effect in computed tomography using the thick slice scanning mode was discussed as a possible explanation for this early visualization. The question of how slice thickness affects the age intervals between ossification stages identified by CT examinations should be examined in additional studies. 相似文献
10.
Radiological analysis of the hand skeleton is a key pillar of forensic age diagnostics in living subjects undergoing criminal
proceedings. The present study investigated whether ossification stage classification of selected epiphyses of the hand could
provide added value to hand radiograph analysis. Hand radiographs from 265 male and 164 female subjects aged 10–18years old
who had been X-rayed due to traumatological indications were therefore assessed. Epiphyseal ossification of selected elements
of the hand skeleton (ulna, radius and third metacarpal, basal phalanx, mesophalanx and telephalanx) was graded based on the
criteria of the five-stage classification system of Schmeling et al. (Int J Legal Med, 118:5–8, 2004) for clavicular epiphyseal
cartilage. Stage 5 (absence of the epiphyseal scar) does not occur in the radius of men before the age of 18. Stage 5 can
therefore be regarded as a potential parameter for valid determination of a minimum age of 18 years for forensic age estimation
in criminal proceedings. 相似文献
11.
Establishing radiation-free imaging methods for the assessment of clavicular ossification in forensic age determination is desirable as it reduces radiation exposure in living individuals. For this purpose the stage of ossification of the right medial clavicular epiphysis was determined prospectively using sonography in 309 male and 307 female healthy volunteers. The classification of stages according to Schulz et al. was used for this purpose. Stage 2 was first noticed at the age of 14.4 years in males, and at the age of 14.1 years in females. Stage 3 was first achieved by males at the age of 17.6 years and by females at the age of 17.4 years. Stage 4 first occurred in males at the age of 19.3 years and at the age of 18.9 years in females. The mean age for stage 1 was 13.6 years. The mean age of stage 2 ranged between 17.3 and 17.6 years. For stage 3 the mean age varied from 20.7 to 21.2 years, and for stage 4 from 23.3 to 23.5 years. It was concluded that sonographically determined stage 4 clavicular ossification provides evidence for the completion of the nineteenth year of life in males and the eighteenth year of life in females. In order to increase the reliability of age determination using this method it is recommended that findings be recorded by at least two experienced independent examiners who then reach a consensus. 相似文献
12.
Due to the increasing significance of forensic age estimations in the age of globalisation, novel radiographic criteria besides clavicles and hand bones may provide additional certainty for forensic age expertises. The present study analyses the suitability of the iliac crest apophysis by means of 643 pelvic radiographs of patients between 10 and 30 years of age. Retrospective assessments were carried out according to the forensically established classification and sub-classification systems modified after Kreitner et al. (Rofo 166(6):481–486, 1997) and Kellinghaus et al. (Int J Legal Med 124(4):321–325, 2010). The basic ossification stages range from 1 to 4, and the sub-stages of stage 2 and 3 range from a to c. While stage 3c was first achieved at the age of 15 by both sexes, stage 4 was first observed in females at the age of 16 and in males at the age of 17. This indicates the possibility of a valid diagnosis of both the age of 14 and the age of 16 years which represent legally relevant age thresholds in numerous countries. Applied as targeted radiography on the iliac crest, the exposure to radiation would range between other radiographic techniques recently applied. Therefore, the iliac crest apophysis appears principally suitable as novel possible criterion for forensic age estimation in the living. However, for the establishment of the iliac crest apophysis in routine diagnostics, further studies are needed focussing on the comparison of different grading systems and different radiological techniques. 相似文献
13.
When preparing forensic age estimates for living subjects over 18 years of age, it is crucial to evaluate the stage of ossification
of the medial clavicular epiphysis. The establishment of radiation-free imaging techniques for assessment of clavicular ossification
would be desirable in order to reduce the radiation exposure associated with forensic age estimations. In the present study,
84 right clavicles of test subjects 12–30 years of age were prospectively evaluated by means of ultrasound. Ossification stage
classification was possible in 80 of the 84 medial clavicular epiphyses studied. In the remaining cases, stage classification
was not possible due to the presence of developmental anomalies. The earliest ages at which the respective ossification stages
were observed were 17.1 years for stage 2, 16.7 years for stage 3, and 22.5 years for stage 4. The age intervals observed
for the ossification stages are consistent with the known data from radiological and computed tomography assessments. The
present study results should be confirmed in a larger number of cases and with analysis of observer variability. Evaluation
of medial clavicular epiphyseal ossification by ultrasound could ultimately be a rapid and economic non-ionizing diagnostic
imaging procedure for forensic age estimation. 相似文献
14.
Determination of the stage of ossification of the medial clavicular epiphysis is a crucial part of age estimation in criminal
proceedings when evaluating individuals with completed hand ossification. In order to ensure a maximum of accuracy in forensic
age estimation practise, it is recommended to perform thin-slice CT scans; but to date there exist no reference data on the
bone development of the region in question based on thin-slice computed tomography. In this retrospective study, the authors
evaluated thin-slice multidetector CT images of 592 individuals aged between 10 and 35 years produced in the University Hospital
of Münster. The ossification status of the medial epiphysis of the clavicle could be reliably determined in 502 cases using
the classification of stages by Schmeling et al. In male individuals, stage 2 was first noted at age 14, in female individuals
at age 13. Stage 3 was first achieved by male individuals at age 17, by female individuals at age 16. The occurrence of stage
4 was first found in both sexes at the age of 21. In either sex, the earliest observation of stage 5 was at age 26. The findings
are basically in line with those from the only CT-based study on the subject in question using the same classification of
five stages, except from the fact that in the present study, stage 5 first occurs at age 26, which is 4 or 5 years later than
what was found in the CT study using 7 mm slices in the majority of cases. This vast difference may be explained through the
partial volume effect occurring with thick-slice CT images by a visual deception of the epiphyseal scar occurring with stage
4. 相似文献
15.
Forensic age estimation is a crucial aspect of the identification process. While epiphyseal fusion of long bones has been studied for age estimation since a long time, over the past few years, the role of medial clavicular epiphyseal fusion in age estimation is being explored. The medial clavicular epiphyseal fusion can be used to estimate age in young adults, and can also determine whether medicolegally significant ages of 16 and 18 years have been attained by an individual. The present study aimed at generating regression models to estimate age by evaluating the medial clavicular epiphyseal fusion in Indian population using Schmeling et al. and Kellinghaus et al. method, and to assess whether an individual’s age is over medicolegally significant thresholds of 16 and 18 years. Degree of ossification of the medial clavicular epiphysis was studied in CT images of 350 individuals aged 10.01–35.47 years. Significant statistical correlation (P < 0.001) was observed between the degree of fusion and the chronological age of the participants, with Spearman’s correlation (ρ) = 0.918 in females, and ρ = 0.905 in males. Regression models were generated using degree of ossification of medial end of clavicle of 350 individuals (147 females and 203 males) and these models were applied on a test set of 50 individuals (25 females and 25 males). Mean absolute error of 1.50 for females, 1.14 for males, and 1.32 for the total test set was observed when the variance between the chronological ages and estimated ages was calculated. 相似文献
16.
The evaluation of the medial clavicular epiphysis via CT plays an important role in the determination of age, particularly the 19th and 22nd ages. Several authors have recommended the use of the Schmeling and Kellinghaus methods in conjunction in the evaluation of the medial clavicular epiphysis. The aim of this retrospective study was to evaluate thin section CT scan images of the medial clavicular epiphysis according to the Schmeling and Kellinghaus method, and to discuss the obtained data in the light of the literature. The thoracic CT scan images (0.6 mm section thickness) of 601 patients (202 female and 399 male) aged between 10 and 35 years obtained by 16-detector CT were evaluated by two examiners. The stage 2 was seen between 13 and 23 years of age; stage 3 was seen between 16 and 27 years of age. However, 100% of the female cases with stage 3c were ⩾18 years of age, and 100% of the male cases with stage 3c were ⩾19 years of age. Stage 4 was first observed at 20 years of age in both sexes, and stage 5 was first observed at 25 years of age in both sexes. We believe that stage 3c may be used, particularly in the determination 18-year age limit for both sexes. The outcomes of our study are consistent with those of our previous study and other studies in the literature, which is important for the confirmation of the reliability of the method. 相似文献
17.
Computed tomography scans originally obtained to assess the ossification status of the medial clavicular epiphyses of 40 live
subjects for forensic age estimation purposes were analysed. From the data acquired we reconstructed images with slice thicknesses
of 1, 3, 5 and 7 mm, and based on the classification of stages by Schmeling et al. (Int J Legal Med 118:5–8, 2004), we determined
the ossification stage for each reconstructed slice thickness, separately for both sides. Of the 80 clavicular epiphysial
plates examined, seven displayed slice-thickness-dependent differences at certain ossification stages. In one case a slice
thickness of 1 mm led to a different diagnosis of the ossification stage than a slice thickness of 3 mm, in three cases the
diagnoses differed between the slice thicknesses of 3 and of 5 mm, and in another three cases, between 5 and 7 mm. We therefore
conclude that for age estimation purposes, the slice thickness should be 1 mm to ensure maximum accuracy and diagnostic reliability. 相似文献
18.
The assessment of the ossification status of the medial clavicular epiphysis plays a decisive role in forensic age diagnostics to determine whether a person has completed his or her 18th or, respectively, 21st year of life. Currently, computed tomography is the gold standard method for age diagnostics of this kind. However, efforts are being made to establish non-ionizing methods, such as ultrasonography, predominantly, in an attempt to reduce the radiation exposure load of living persons. The present study is the first to score and to compare the ossification status of both medial clavicular epiphyses of the same subjects by sonography, computed tomography, and, in some of the cases, by macroscopy. Our study was conducted on five male corpses, ranging in age from 15.8–28.8 years. In the comparison of high-resolution sonography (frequency, 12–15 MHz) and thin slice computed tomography (slice thickness, 0.6 mm), performed separately for left and right clavicles, the results from these two methods differed in seven of ten cases. In six cases, the ossification stage of the medial clavicle, determined by sonography and classified according to Schulz et al. (2008), was scored higher than with computed tomography. In one case, it was rated lower. There was only one subject for whom both the sonographic and computed tomography findings agreed for both body sides. 相似文献
19.
Evaluation of the developmental stage of the hand skeleton is an essential part of forensic age diagnostics in living individuals involved in criminal proceedings. Skeletal age determination of the hand is mainly based on the development of the epiphyseal centers of ossification, growth of the individual bones and of the entire hand skeleton, modification of the various skeletal elements as well as ossification of the epiphyseal cartilage. Various procedures to determine the skeletal age of the hand as well as the different methodological approaches are presented. Several procedures which have been established in clinical practice have been studied in terms of forensic applicability. According to current knowledge the so-called atlas methods are particularly recommendable for forensic age diagnostics. 相似文献
20.
Due to the requirement to minimise exposure to radiation, it is desirable to develop non-ionising imaging procedures for the
analysis of skeletal maturation for forensic age diagnostics in living individuals. The present pilot study analyses the applicability
of ultrasound examinations for the evaluation of apophyseal ossification of the iliac crest. With reference to the sonographic
staging of clavicular ossification, the maturation stages of the iliac crest apophysis of 23 male and 16 female subjects,
aged 11–20 years, were determined. Ossification stage I occurred in the male subjects at a minimum age of 15.7 years. Ossification
stage II was diagnosed in boys at a minimum age of 14.1 years and in girls at a minimum age of 11.7 years. The earliest observation
of ossification stage III was at a chronological age of 16.2 years in males and 15.2 years in females. The earliest age of
occurrence of ossification stage IV was at least 18.0 years in male test persons and at least 17.1 years in female test persons.
The results obtained should be reassessed in a larger number of cases. It is to be expected that sonographic examination of
the iliac crest apophysis will become established as a valid and efficient method for forensic age diagnostics in living individuals. 相似文献
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