To 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The aim of the current study was to retrospectively collect dental panoramic radiographs from Somali children living in Finland, to use the radiographic data to develop a new age estimation model based on the model established by Willems et al. (J Forensic Sci 46(4):893–895, 2001), and to compare the age prediction performances of the Willems et al. model (WM) and the newly developed model.
Material and methodsDental panoramic radiographs from 808 healthy Somalis born in Finland were selected. The development of the seven left mandibular permanent teeth, from the central incisor to the second molar, was staged according to Demirjian et al. (Hum Biol 45(2):211–227, 1973). Radiographs with all listed permanent teeth completely developed were excluded. The studied sample consisted of 635 subjects (311 females, 324 males) ranging in age from 4 to 18 years. Kappa and weighted Kappa statistics were used to quantify intra- and inter-observer agreement in stage allocation. The collected dataset was used to validate the WM, constructed on a Belgian Caucasian reference sample, and to establish a Somali-specific age estimation model (SM) based on the WM. Both models were validated and their age prediction performances quantified using mean error (ME), mean absolute error (MAE) and root mean squared error (RMSE).
ResultsThe SM resulted in a slight underestimation of age when the sex groups were analysed separately or combined, with ME varying between 0.04 (standard deviation (SD) 1.01) and 0.05 (SD 1.04) years, MAE between 0.77 and 0.80 years and RMSE between 1.01 and 1.04 years. The WM statistically significantly underestimated the age of females, with an ME of 0.20 (SD 1.01) years (p = 0.0006). For males, and for females and males combined, no statistically significant ME was observed.
ConclusionThe WM and SM were similar in their age prediction performances, and the use of the WM in dental age assessment in the Somali population is justified.
相似文献Age estimation using developing third molar teeth is considered an important and accurate technique for both clinical and forensic practices. The aims of this study were to establish population-specific reference data, to develop age prediction models using mandibular third molar development, to test the accuracy of the resulting models, and to find the probability of persons being at the age thresholds of legal relevance in a Thai population. A total of 1867 digital panoramic radiographs of Thai individuals aged between 8 and 23 years was selected to assess dental age. The mandibular third molar development was divided into nine stages. The stages were evaluated and each stage was transformed into a development score. Quadratic regression was employed to develop age prediction models. Our results show that males reached mandibular third molar root formation stages earlier than females. The models revealed a high correlation coefficient for both left and right mandibular third molar teeth in both sexes (R = 0.945 and 0.944 in males, R = 0.922 and 0.923 in females, respectively). Furthermore, the accuracy of the resulting models was tested in randomly selected 374 cases and showed low error values between the predicted dental age and the chronological age for both left and right mandibular third molar teeth in both sexes (−0.13 and −0.17 years in males, 0.01 and 0.03 years in females, respectively). In Thai samples, when the mandibular third molar teeth reached stage H, the probability of the person being over 18 years was 100 % in both sexes.
相似文献The age of majority, which corresponds to the age of 18 years in most European countries, plays a crucial role for a large number of legal decisions. Accordingly, an increasing number of requests by authorities to forensic age estimation experts comprise the question of whether the age of 18 years has been reached by an individual. In recent years, novel study data suggested that magnetic resonance imaging (MRI) of the knee might likewise allow for the determination of majority beyond reasonable doubt. However, the data basis, especially concerning the distal femoral epiphysis (DFE), is still poor. For this reason, 392 routine MRI cases of the knee (204 males and 188 females of a Western Caucasian population, aged between 12 and 25 years) were retrospectively analyzed. T1-weighted and water-selective fat-saturated PD/T2-weighted sequences, generated at 1.5 and 3.0 T clinical MR scanners, were available. Ossification stages of the DFE were determined by means of the classification system by Vieth et al. (Eur Radiol 2018; 28:3255–3262). Both the intra-observer agreement and inter-observer agreement were found to be “very good” (κ = 0.899 and κ = 0.830). The present study confirmed that MRI of the DFE is suitable to determine majority in both sexes when stage 6 is present as the study revealed minimum ages above the age of 18 years for this stage (20.40 years in males and 20.60 years in females). Accordingly, the data represent a strong support for the so far existing database. Hence, the investigation of the knee using routine MRI appears to become a realistic alternative for forensic age estimation practice in the near future.
相似文献In forensic medicine and many other fields, age estimation by the use of teeth is of great importance for the purpose of individual identification. In the past, however, age estimation based on the second molar mineralization was scarcely performed. In this study, a total of 1657 panoramic radiographs taken from 834 males and 823 females of northern Chinese origin in the age bracket 5 to 25 years were assessed. The mineralization status of the second molars was determined using the classification described by Demirjian et al. Results showed that the left and right, as well as maxillary and mandibular second molars were generally at similar stages of mineralization. The maxillary left second molars (27) at stage D, mandibular left second molars (37) at stages C, D, F, and G, and mandibular right second molars (47) at stages D, F, and G showed a significantly lower average age in female subjects than in male subjects. In males, fully developed second molars first appeared with 12 years of age; in females, stage H occurred with 11 years at the earliest. One male individual and one female individual with second molars showing stage G were 23 years old. It was concluded that second molars showing stage H do not exclude an age under 14 years and that second molars showing stage G do not exclude an age above 18 years.
相似文献Recent research concerning tooth development and dental agenesis suggests that specific genes are associated with agenesis, and that these genetic factors could also cause delayed dental development of the remaining teeth. The objective of this study was to evaluate whether dental development of patients with agenesis is delayed, compared to a control group.
Subjects and methodPanoramic radiographs of 1145 patients with dental agenesis were collected (452 males, 693 females) aged 6.2 to 24.8 years. The control group included 2032 panoramic radiographs (977 males, 1055 females) aged 6.0 to 24.4 years. A total of 3177 orthopantomograms were staged according to Demirjian. All left permanent teeth present in the mandible (except third molars) were considered. In order to evaluate the difference between patients with and without agenesis, a developmental score (DS) was calculated. The association between the DS and the number of agenetic teeth was evaluated with a Spearman correlation.
ResultsBased on the DS, patients with agenesis have a delayed development compared to patients in the control group (p < 0.0001). Within the agenesis group, there is a weak relation between the number of agenetic teeth and the DS: the higher the number of teeth with agenesis, the lower the DS (p < 0.0001 and p = 0.06 for females and males, respectively).
ConclusionThe obtained results can be an important factor for treatment planning in patients with dental agenesis. Moreover, the presence of agenesis needs to be taken into account when using age estimation methods based on permanent tooth development.
相似文献Age estimation is essential to the human identification process, both in forensic and archeological contexts. Based on the previous male-specific method of Rissech et al. (J Forensic Sci, 2006, 51:213–229), a new approach to age estimation based on the acetabulum has been described and evaluated in 611 individuals from the Lisbon Collection (Lisbon, Portugal). This paper has two main goals: (1) to revise and better define the variables of Rissech’s method related to the acetabular fossa, namely, variables 5, 6, and 7, and (2) to extend the applicability of this new approach to both sexes while analyzing age-related sex differences in the acetabular aging process. The results demonstrate the suitability of combining acetabulum traits and a Bayesian approach to estimating age in adults of both sexes. This study has confirmed the usefulness of the redefined variables of the acetabular fossa when age-related changes are considered. Furthermore, the newly defined variables have good to excellent values of repeatability. The study has also extended the method’s applicability to females. The revised method has absolute error averages of 7.28 years for males and 7.09 years for females, based on a sex-specific reference sample. In addition, approximately 74 % of the individuals estimated had an absolute error less than 10 years. Interestingly, the acetabular aging process follows similar trends in both sexes, but the aging rate seems to be different between males and females, especially in middle-aged individuals. Despite the fact that the age estimates, on average, did not improve significantly with the use of a sex-specific reference sample, it is recommended that the sexes be analyzed separately due to the differences in aging rates and inaccuracy values.
相似文献To present a new blunt-tip coaxial needle (SoftGuard) applied to access “hard-to-reach” targets undergoing percutaneous image-guided biopsy or drainage.
Materials and MethodsAll consecutive patients presenting between August and December 2016 with “hard-to-reach” (<10 mm from a critical nearby structure such as vessels, nerves, bowel or adjacent parenchymal organs) solid lesions requiring biopsy (group A) or abscesses requiring drainage for sepsis (group B) were prospectively included. The individual features of each patient and lesion as well as technical and clinical data were collected and analysed.
ResultsTwenty-six patients (18 males, 8 females, mean age 59.81 ± 17.53 years) were enrolled in group A and nine (6 males, 3 females, mean age 58.33 ± 13.8 years) in group B. Technical success was achieved in 92.3% of cases from group A and 100% of cases from group B. Five (19.2%) minor complications were noted in group A (four small self-limiting pneumothoraces and one small self-limiting peri-pancreatic haematoma). There were no complications in group B. Histological results in group A accounted for 95% sensitivity, 100% specificity and 95.2% diagnostic accuracy. In group B, mean post-operative C-reactive protein was 41 ± 48.3 mg/L in comparison with 155 ± 117.5 mg/L at baseline (P = 0.004).
ConclusionsThe SoftGuard blunt-tip needle is a safe and effective tool when applied as a coaxial working cannula for percutaneous biopsy or drainage of “hard-to-reach” targets.
相似文献The accurate age at death assessment of unidentified adult skeletal individuals is a critical research task in forensic anthropology, being a key feature for the determination of biological profiles of individual skeletal remains. We have previously shown that the age-related decrease of bone mineral density (BMD) in the proximal femur could be used to assess age at death in women (Navega et al., J Forensic Sci 63:497–503, 2018). The present study aims to generate models for age estimation in both sexes through bone densitometry of the femur and radiogrammetry of the second metacarpal. The training sample comprised 224 adults (120 females, 104 males) from the “Coimbra Identified Skeletal Collection,” and different models were generated through least squares regression and general regression neural networks (GRNN). The models were operationalized in a user-friendly online interface at https://osteomics.com/DXAGE2/. The mean absolute difference between the known and estimated age at death ranges from 9.39 to 13.18 years among women and from 10.33 to 15.76 among men with the least squares regression models. For the GRNN models, the mean absolute difference between documented and projected age ranges from 8.44 to 12.58 years in women and from 10.56 to 16.18 years in men. DXAGE 2.0 enables age estimation in incomplete and/or fragmentary skeletal remains, using alternative skeletal regions, with reliable results.
相似文献Many surgeons are still hesitant to do arthroscopic anterior cruciate ligament reconstruction (ACL) in patients above 40 years old.
PurposeThe effect of ACL reconstruction on functional outcomes in patients above 40 years of age.
Materials and methodsPatients of age?>?40 years who underwent ACL reconstruction were enrolled in the study. Functional outcomes (Lysholm, WOMAC score, and Tegner activity scale), pain (VAS score), and knee stability (KT-1000) were assessed at final follow-up and compared with pre-operative scores. All patients were followed up for a minimum of 2 years.
ResultsA total of 112 patients were included in the study. Eighty-eight were males and 24 were females. The mean age at the time of surgery was 44.8?±?5.6 years (40–63 years). The mean Lysholm score was improved from 64.1?±?11.7 to 87.2?±?5.9 (p?=?0.0001). Similarly, the WOMAC score was also improved from 8.8?±?6.9 to 2.3?±?1.9 (p?=?0.0001). The mean side-to-side difference (KT-1000) also improved from 6.65?±?2.25 mm to 2.32?±?1.45 mm (p?=?0.0001). More than 70% of the patients had excellent or good outcomes. Median pre-injury Tegner activity scale was 5 (3–8) and the median post-ACLR Tegner activity scale was 5 (3–7; p?=?1).
ConclusionACL reconstruction in patients?>?40 years of age results in good functional outcomes and knee stability.
相似文献The aim of this paper is to investigate ageing changes in craniofacial region in both sexes and evaluate whether these shape changes are substantial to achieve age discrimination of samples used in anthropological analyses. The study sample consisted of 157 crania of known sex and age (81 males and 76 females) belonging to individuals who lived in Greece during the twentieth century. The sample was divided in three age groups: young adults (YA, 18–39 years old), middle adults (MA, 40–59 years old) and old adults (OA, >60 years old). The three-dimensional coordinates of 31 ecto-cranial landmarks were digitized using a Microscribe 3DX contact digitizer, and landmark configurations were analyzed using the generalized least-squares Procrustes method. The results indicate that both males and females show significant difference among the age groups; however, shape differences can not be used for age group discrimination due to a large range on the accuracy of age group classification. The morphometric changes related to age were different between sexes.
相似文献In forensic age assessment of living individuals, developmental stages of skeletal maturation and tooth mineralization are examined and compared with a reference population. It is of interest which factors can affect the development of these features. We investigated the effect of body mass index (BMI) on the developmental stages of the medial epiphysis of the clavicle, the distal epiphysis of the radius, the distal epiphysis of the femur, the proximal epiphysis of the tibia, and the left lower third molar in a total of 581 volunteers, 294 females and 287 males aged 12–24 years, using 3 T MRI. BMI values in the cohort ranged from 13.71 kg/m2 in a 12-year-old female to 35.15 kg/m2 in an 18-year-old female. The effect of BMI on the development of the characteristics was investigated using linear regression models with multivariable fractional polynomials. In the univariable analysis, BMI was associated with all feature systems (beta between 0.10 and 0.44; p < 0.001). When accounting for the physiological increase of BMI with increasing age, the effect of BMI was lower and in the majority of the models no longer clinically relevant. Betas decreased to values between 0.00 and 0.05. When adding feature variables to a model already including age, r2 values increased only minimally. For an overall bone ossification score combining all characteristics, the adjusted ß was 0.11 (p = 0.021) and 0.08 (p = 0.23) for females and males, respectively. Low ß and r2 values (0.00 (adjusted)–0.16 (crude)) were present in both models for third molar development already in the unadjusted analyses. In conclusion, our study found no to little effect of BMI on osseous development in young adults. Teeth development in both sexes was completely independent of BMI. Therefore, dental methods should be part of every age assessment.
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