Abstract：
OBJECTIVE: In forensic age estimation e.g. for judicial proceedings surpassed age thresholds can be legally relevant. To examine age related differences in skeletal development the recommendations by the Study Group on Forensic Age Diagnostics (AGFAD) are based on ionizing radiation (among others orthopantomograms, plain x-rays of the hand). Vieth et al. and Ottow et al. proposed MRI-classifications for the epiphyseal-diaphyseal fusion of the knee joint to define different age groups in healthy volunteers. The aim of the present study was to directly compare these two classifications in a large German patient population.
METHODS: MRI of the knee joint of 900 patients (405 female, 495 male) from 10 to 28 years of age were retrospectively analyzed. Acquired T1-weighted turbo spin-echo sequence (TSE) and T2-weighted sequence with fat suppression by turbo inversion recovery magnitude (TIRM) were analyzed for the two classifications. The different bony fusion stages of the two classifications were determined and the corresponding chronological ages assigned. Differences between the sexes were analyzed. Intra- and inter-observer agreements were determined using Cohen\'s kappa.
RESULTS: With the classification of Ottow et al. it was possible to determine completion of the 18th and 21st year of life in both sexes. With the classification of Vieth et al. completion of the 18th year of life for female patients and the 14th and 21st year of life in both sexes could be determined. The intra- and inter-observer agreement levels were very good (κ > 0.82).
CONCLUSIONS: In the large German patient cohort of this study it was possible to determine the 18th year of life with for both sexes with the classification of Ottow et al. and for female patients with the classification of Vieth et al. It was also possible to determine the 21st year of life for all bones with the classification of Ottow et al. and for the distal femur with the classification of Vieth et al.
METHODS: MRI of the knee joint of 900 patients (405 female, 495 male) from 10 to 28 years of age were retrospectively analyzed. Acquired T1-weighted turbo spin-echo sequence (TSE) and T2-weighted sequence with fat suppression by turbo inversion recovery magnitude (TIRM) were analyzed for the two classifications. The different bony fusion stages of the two classifications were determined and the corresponding chronological ages assigned. Differences between the sexes were analyzed. Intra- and inter-observer agreements were determined using Cohen\'s kappa.
RESULTS: With the classification of Ottow et al. it was possible to determine completion of the 18th and 21st year of life in both sexes. With the classification of Vieth et al. completion of the 18th year of life for female patients and the 14th and 21st year of life in both sexes could be determined. The intra- and inter-observer agreement levels were very good (κ > 0.82).
CONCLUSIONS: In the large German patient cohort of this study it was possible to determine the 18th year of life with for both sexes with the classification of Ottow et al. and for female patients with the classification of Vieth et al. It was also possible to determine the 21st year of life for all bones with the classification of Ottow et al. and for the distal femur with the classification of Vieth et al.
摘要：
目的：在法医年龄估计中，例如在司法程序中超过年龄阈值可能具有法律相关性。为了检查骨骼发育中与年龄相关的差异，法医年龄诊断研究小组（AGFAD）的建议基于电离辐射（除其他外，手的普通X射线）。Viethetal.和Ottow等人。提出了膝关节骨-骨干融合的MRI分类，以定义健康志愿者的不同年龄组。本研究的目的是在大量德国患者人群中直接比较这两种分类。
方法：900例患者的膝关节MRI（405名女性，回顾性分析了495名10至28岁的男性）。对两种分类进行了分析，分析了通过涡轮反转恢复幅度（TIRM）获得的T1加权涡轮自旋回波序列（TSE）和T2加权序列的脂肪抑制。确定了两种分类的不同骨融合阶段，并分配了相应的实际年龄。分析了两性之间的差异。观察者内部和观察者之间的协议是使用科恩的kappa确定的。
结果：根据Ottow等人的分类。可以确定男女的18岁和21岁是否完成。根据Vieth等人的分类。可以确定女性患者的18岁寿命以及男女的14岁和21岁寿命。观察者内部和观察者之间的一致水平非常好(κ>0.82)。
结论：在本研究的大型德国患者队列中，可以根据Ottow等人的分类来确定男女的18岁寿命。和女性患者的分类为Vieth等人。也可以通过Ottow等人的分类来确定所有骨骼的第21年寿命。对于股骨远端，采用Vieth等人的分类。
方法：900例患者的膝关节MRI（405名女性，回顾性分析了495名10至28岁的男性）。对两种分类进行了分析，分析了通过涡轮反转恢复幅度（TIRM）获得的T1加权涡轮自旋回波序列（TSE）和T2加权序列的脂肪抑制。确定了两种分类的不同骨融合阶段，并分配了相应的实际年龄。分析了两性之间的差异。观察者内部和观察者之间的协议是使用科恩的kappa确定的。
结果：根据Ottow等人的分类。可以确定男女的18岁和21岁是否完成。根据Vieth等人的分类。可以确定女性患者的18岁寿命以及男女的14岁和21岁寿命。观察者内部和观察者之间的一致水平非常好(κ>0.82)。
结论：在本研究的大型德国患者队列中，可以根据Ottow等人的分类来确定男女的18岁寿命。和女性患者的分类为Vieth等人。也可以通过Ottow等人的分类来确定所有骨骼的第21年寿命。对于股骨远端，采用Vieth等人的分类。
