title: Correlation between age and the parameters of medial epiphysis and metaphysis of the clavicle using CT volume rendering images.
abstract: OBJECTIVE
  The aim of this study was to evaluate the correlation between age and the parameters of medial epiphysis of clavicle based on CT volume rendering (VR) images.
  
  
  METHODS
  The CT images of the medial clavicle from 795 teenagers (387 male and 408 female) between 15 and 25 years were collected in East and South China. VR images were recombined from 0.60 mm thickness slice CT images. The ratio of epiphyseal diameter/metaphyseal diameter and the ratio of epiphyseal area/metaphyseal area of two sides of medial clavicle were measured and calculated by three different examiners, the quantitative data consistency was checked by intraclass correlation coefficients (ICC). The diameter ratio of left and right side are depicted as X1 and X3, and the area ratio of left and right side as X2 and X4. Descriptive statistic analysis of the data was performed and several mathematical models were established using least square. CT images from additional 60 teenagers (30 male and 30 female) were used to verify the accuracy of the established mathematical models.
  
  
  RESULTS
  ICC indicated that the measurement of epiphyseal diameter, metaphyseal diameter, the ratio of epiphyseal diameter/metaphyseal diameter, epiphyseal area, metaphyseal area and the ratio of epiphyseal area/metaphyseal area of medial clavicle in the left and right side of the three examiners was approaching 1. The 95% reference range for the mean of every examination of both genders gradually increased with age. Females' data indicated by medial epiphysis of the clavicle development were earlier than male's, especially from 15 to 21 years. The difference of medial epiphysis of the clavicle development in gender becomes smaller after 21 years. The highest accuracy of the mathematical models made clear that male's accuracy was 73.5% (±1.0 year) and 85.3% (±1.5 year), and female's was 68.6% (±1.0 year) and 82.2% (±1.5 year) respectively.
  
  
  CONCLUSIONS
  The methods of data collection and analysis were reliable and feasible. Combined the high accuracy of these established mathematical models, it is applicable to use the ratio of epiphyseal diameter/metaphyseal diameter and the ratio of epiphyseal area/metaphyseal area of left and right side of medial clavicle to estimate the teenager's age. Bearing this in mind, further studies are needed to evaluate slice thickness as the most critical parameter.
authors.affiliation: Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai 200063, P.R. China; East China University of Political Science and Law, Shanghai 200042, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hua
authors.affiliation: Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai 200063, P.R. China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Guang-you
authors.affiliation: Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai 200063, P.R. China.
authors.forename: Wan
authors.initials: W
authors.lastname: Lei
authors.affiliation: Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai 200063, P.R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chong-liang
authors.affiliation: Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai 200063, P.R. China. Electronic address: wangyh@ssfjd.cn.
authors.forename: Wang
authors.initials: W
authors.lastname: Ya-hui
mesh_terms: D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton / Q000379:methods*; D002968:Clavicle / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D004838:Epiphyses / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D005260:Female; D018732:Forensic Anthropology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D015233:Models, Statistical; D061330:Multidetector Computed Tomography; D055815:Young Adult
keywords: Age estimations; Clavicle Medical epiphysis; Computed tomography; Forensic anthropology; Population data; Volume Rendering