Applicability of proximal humeral epiphysis ossification for forensic age estimation according to the Vieth method: a 3.0 T MRI study

A retrospective study was conducted to explore the possibility of determining the age of majority via examination of the proximal humeral epiphyseal-diaphyseal fusion by 3.0 T magnetic resonance imaging (MRI) using the Vieth classification. Proximal humeral epiphyses were retrospectively studied on 3.0 T MRI in 315 participants (122 females, 193 males) between 10 and 28 years of age, using T1-weighted turbo spin echo (T1W TSE) and proton density fat-saturated TSE sequence (PD FS TSE). A 5-stage scoring system was used following the method of Vieth et al. The relevant statistics were defined, the intraobserver and interobserver agreements were determined (Cohen's kappa) and the differences between the sexes were analyzed (Mann-Whitney U-test, p 0.05). The Vieth classification provides important information in determining whether a person has reached the age of 18 years or not in both sexes through 3.0 T MRI of the shoulder joint.WOS:0006189107000012-s2.0-8510106095

Smartphone evaluation of postero-anterior chest x-rays: An inter-observer study

Background: Posterior-anterior chest x-ray (PA-CXR) is among the most commonly used imaging methods in the diagnosis both in the emergency departments (ED) and the other clinics. The aim of the present study was to evaluate the diagnostic reliability of PA-CXRs sent via a smartphone. Methods: This study was conducted as an inter-observer study. PA-CXRs were photographed with a smartphone and they were sent to two separate participants (emergency medicine specialists one with 4 years experience and another with 3) via the WhatsApp application. And the participants evaluated to these images on their mobile phone. Results: A poor concordance was determined in a ratio of 3/8 and good concordance was detected in a ratio of 3/8 between the two participants (p < 0.05). It was observed that only the mediastinum assessments could be an alternative to the gold standard (p < 0.01). Conclusion: We may conclude that the assessments done via a smartphone (photographing and sharing) may not be reliable. (C) 2020 Elsevier Inc. All rights reserved.WOS:0006813086000152-s2.0-85095784686PubMed: 3317274

Evaluation of proximal humeral epiphysis ossification in 3.0 T MR images according to the Dedouit staging method: Is it be used for age of majority?

Magnetic resonance imaging (MRI) for forensic age estimation is among the research issues since it does not lead to radiation exposure. In this study, the ossification stage of the proximal humeral epiphysis was determined retrospectively in 178 male and 109 female individuals in the 12 to 30-year age group using 3.0 T MRI. All images were evaluated with the proton density fat saturated turbo spin echo (PD TSE FS) sequence and the T2 TSE FS sequence. A five-stage scoring system was used following the method of Dedouit et al. The relevant statistics were defined as minimum, maximum, mean +/- standard deviation, 95% confidence interval of mean and median and the intra- and interobserver agreement levels were very good (kappa > 0.80). There were no significant age differences between males and females in any of the stages (all p-values>0.05). According to the present study, stage 5 was initially observed at age 22 years for both genders. According to our results, it is possible to determine the completion of the 18th year of life in either gender on the shoulder joint. Proximal humeral epiphysis ossification may be used as an additional method for forensic age estimation through MRI.WOS:0006136185000142-s2.0-85097751141PubMed: 3333880

Isolated CA 19-9 Elevation as Preceding Finding of Colorectal Carcinoma

Rectal bleeding, change in bowel habits, abdominal pain are cardinal symptoms of colorectal carcinoma. Otherwise, weight loss, fatigue and weakness do not suggest colorectal carcinoma. Carbohydrate antigen (CA) 19-9 level is higher in several malignancies, especially gastrointestinal malignancies, and some benign conditions. Herein, we present a patient who is referred to our clinic with the complaint of fatigue and significant CA 19-9 elevation, diagnosed as metastatic colorectal carcinoma. Presenting case highlights that CA 19-9 elevation might be the only finding of colorectal carcinoma in even patients with nonspecific complaints. [Med-Science 2016; 5(3.000): 914-8

Evaluation of knee ossification on 1.5 T magnetic resonance images using the method of Vieth et al. A retrospective magnetic resonance imaging study

Magnetic resonance imaging (MRI) is a noninvasive method with the absence of ionizing radiation exposure and is therefore, preferable in studies for forensic age estimation. The purpose of this study was to investigate the degree of ossification of the knee in a Turkish population following the Vieth et al. method. We scanned 709 Turkish patients in the age bracket 12-27 years utilizing a T1weighted (T1W) turbo spin echo sequence (TSE) and a T2-W TSE sequence with fat suppression by spectral presaturation with inversion recovery. Minimum, maximum, mean +/- standard deviation andmedian values were defined. Intraobserver and interobserver correlations were determined (Cohen's kappa). The statistical relevance of sex-related differences was analyzed (Student's t-test, Mann-Whitney U-test, p< 0.05, exact test, two-sided). The kappa statisticswere relatively high, indicating very good agreement for interobserver and intraobserver evaluations. Comparison of male and female data revealed significant between-gender differences for most stages (p< 0.05). The earliest mean ages at which ossification of stages 4, 5 and 6 were evident in the distal femoral epiphysis were 14.84, 15.81, and 20.76 years in males and 13.77, 14.77, and 20.45 years in females, respectively. Proximal tibial epiphysis of stages 4, 5, and 6 ossification was first noted at ages 13.57, 15.59, and 18.91 years in males and 13.29, 14.38, and 16.87 years in females, respectively. In the distal femoral epiphysis, stage 6 was found at 20 years of age for both genders and it can be employed to differentiate above and below the majority age cut-off.WOS:0005833942000012-s2.0-8509382338

Applicability of 3.0 T MRI images in the estimation of full age based on shoulder joint ossification: Single-centre study

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 infra- and inter-observer agreement levels were very good (kappa and kappa(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.WOS:0005798551000242-s2.0-85088640574PubMed: 3273616

Posterior shoulder labrocapsular structures in all aspects; 3D volumetric MR arthrography study

Pathologies of the posterior labrocapsular structures of the shoulder joint are far less common than anterior labrocapsuloligamentous lesions. Most of these pathologies have been associated with traumatic posterior dislocation. A smaller portion of the lesions include posterior extension of superior labral anteroposterior lesions, posterior superior internal impingement, and damage to the posterior band of the inferior glenohumeral ligament. Labrocapsular anatomic variations of the posterior shoulder joint can mimic labral pathology on conventional MR and occasionally on MR arthrographic images. Knowledge of this variant anatomy is key to interpreting MR images and studying MR arthrography of the posterior labrocapsular structure to avoid misdiagnosis and unnecessary surgical procedures. In this article, we review normal and variant anatomy of the posterior labrocapsular structure of the shoulder joint based on MR arthrography and discuss how to discriminate normal anatomic variants from labrocapsular damage.WOS:0006633358000082-s2.0-85108741917PubMed: 3398902

Forensic age estimation in living individuals by 1.5T magnetic resonance imaging of the knee: a retrospective MRI study

Our aim is to analyse proximal tibial epiphysis and distal femoral epiphysis patterns according to the Dedouit staging method using 1.5 T magnetic resonance imaging (MRI) with fast spin echo (FSE) for proton density images. In addition, we discuss the results in relation to the literature for forensic age estimation. In this study, images belonging to 195 female and 277 male patients ranging in age from 10 to 30 years who had a knee MRI for any reason in our Radiology Clinic between January 2014 and December 2016 were retrospectively evaluated. According to the Dedouit et al. five-stage method, they were evaluated by two radiologists. The kappa value was calculated for intra-observer and inter-observer compliance. The evaluation of knee epiphysis patterns from MRI is an alternative, efficient, radiation-free and non-invasive method that is helpful in forensic age estimation. In particular, stage 5 in distal femoral epiphysis can determine the 21st year of life in both sexes, and proximal tibial epiphysis could present evidence of age 18 in males. It should be used for evaluation in addition to other methods for determining skeletal system maturity.WOS:0005448927000082-s2.0-8505761476