利用锁骨内侧骨骺骨化分期鉴定骨龄  

Identification of skeletal age using the ossification staging of medial clavicle epiphysis

作　　者：查璐琴 崔二峰 Zha Luqin;Cui Erfeng(Medical College of Xuchang University,Xuchang 461000,Henan Province,China;Department of Radiology,Xuchang Central Hospital,Xuchang 461000,Henan Province,China)

机构地区：[1]许昌学院医学院,河南省许昌市461000 [2]许昌市中心医院放射科,河南省许昌市461000

出　　处：《中国组织工程研究》2018年第35期5674-5680,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:青少年和年轻成年人的法医学骨龄鉴定一直是刑事诉讼程序中的热点主题。手骨骨化测定、第三磨牙矿化作为国内法医学骨龄鉴定的常用方法,会出现鉴定年龄过大的情况,从而影响司法公正。因此,利用锁骨内侧骨骺骨化分期进行骨龄鉴定就成了一种可替代的新型鉴定手段。目的:利用CT分析锁骨内侧骨骺的骨化分期能否作为法医学骨龄鉴定的有效技术手段,尝试制定相应的骨化分期标准以判断被检者是否为成人。方法:回顾性收集300例年龄10-30岁被检者的胸部CT资料,分析得到300例(600个锁骨)研究对象双侧锁骨内侧骨骺的骨化分期,并将骨化分期与研究对象的生理年龄、性别进行统计分析。利用一个修正后的分期系统,将锁骨内侧骨骺的骨化分期分为Ⅰ-Ⅴ期。结果与结论:(1)锁骨内侧骨骼骨化中心的出现发生于11-21岁,骨化中心的部分融合发生于16-23岁,骨化中心完全融合分别发生于男性的18岁及女性的19岁;(2)当锁骨内侧骨骺的骨化分期在Ⅲ期时,被检者为成人(> 18岁)的概率为70.8%;当骨化分期在ⅢB期、Ⅳ期及Ⅴ期时,无论男性女性,被检者100%为成人(> 18岁);(3)结果表明,利用CT分析锁骨内侧骨骺的骨化分期,可作为法医学骨龄鉴定的有效方法。ⅢB期可作为判断被检者是否为成人(> 18岁)的标准。BACKGROUND:Forensic bone age identification for adolescents has been a hot topic in criminal proceedings.Determination of the bone ossification of the hand and the mineralization of the third molar are common methods for the identification of skeletal age in China,which will have a situation of overassessment,and will affect the justice of the judiciary.Therefore,the identification of skeletal age using the ossification stage of the medial clavicular epiphysis has become an alternative method.OBJECTIVE:To investigate the feasibility of the ossification stage of the medial clavicular epiphysis in forensic bone age determination by CT,and to find a criterion to determine whether an individual is adult or not.METHODS:Chest CT data of 300 patients with an age of 10-30 years were retrospectively evaluated for ossification stage of the bilateral medial clavicular epiphysis(600 clavicles),and were compared with the sex and chronologic age of the individuals.The ossification stage of the medial clavicular epiphyses was classified from stages I to V using a modified staging system.RESULTS AND CONCLUSION:(1)Epiphyseal ossification center appeared from 11 to 21 years old.Partial fusion occurred between 16 and 23 years of age.Complete fusion was first achieved at the age of 18 years for males and 19 years for females.(2)The probability of an individual being>18 years old was 70.8%in stage III and 100%in stages IIIB,IV,and V in females and males.(3)CT evaluation of the medial clavicular epiphysis is helpful in forensic age determination and stage IIIB can be used as a criterion to make the prediction that an individual is older than 18 years.

关 键 词：锁骨内侧骨骺骨化 骨龄鉴定 中国人群 未成年人 成年人 锁骨 骨骺 年龄测定 骨骼 未成年人 成年人 组织工程 

分 类 号：R445[医药卫生—影像医学与核医学]