title: Contribution of the computed tomography of the anatomical aspects of the sphenoid sinuses to forensic identification.
abstract: BACKGROUND
  Body identification is the cornerstone of forensic investigation. It can be performed using radiographic techniques, if antemortem images are available. This study was designed to assess the value of visual comparison of the computed tomography (CT) anatomical aspects of the sphenoid sinuses, in forensic individual identification, especially if antemortem dental records, fingerprints or DNA samples are not available.
  
  
  METHODS
  This retrospective work took place in a French university hospital. The supervisor of this study randomly selected from the picture archiving and communication system (PACS), 58 patients who underwent one (16 patients) or two (42 patients) head CT in various neurological contexts. To avoid bias, those studies were prepared (anonymized, and all the head structures but the sphenoid sinuses were excluded), and used to constitute two working lists of 50 (42+8) CT studies of the sphenoid sinuses. An anatomical classification system of the sphenoid sinuses anatomical variations was created based on the anatomical and surgical literature. In these two working lists, three blinded readers had to identify, using the anatomical system and subjective visual comparison, 42 pairs of matched studies, and 16 unmatched studies. Readers were blinded from the exact numbers of matching studies.
  
  
  RESULTS
  Each reader correctly identified the 42 pairs of CT with a concordance of 100% [97.5% confidence interval: 91-100%], and the 16 unmatched CT with a concordance of 100% [97.5% confidence interval: 79-100%]. Overall accuracy was 100%.
  
  
  CONCLUSIONS
  Our study shows that establishing the anatomical concordance of the sphenoid sinuses by visual comparison could be used in personal identification. This easy method, based on a frequently and increasingly prescribed exam, still needs to be assessed on a postmortem cohort.
authors.affiliation: Forensic Imaging Unit, Neuroradiology, University Hospital of Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Auffret
authors.affiliation: Department of Radiology, Teaching Military Hospital Clermont-Tonnerre, rue Colonel-Fonferrier, 29240 Brest, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Garetier
authors.affiliation: Forensic Imaging Unit, Neuroradiology, University Hospital of Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France.
authors.forename: Idris
authors.initials: I
authors.lastname: Diallo
authors.affiliation: Epidemiology Unit, University Hospital of Dijon, 14, rue Gaffarel, 21079 Dijon cedex, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Aho
authors.affiliation: Forensic Imaging Unit, Neuroradiology, University Hospital of Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France; LaTIM-INSERM UMR 1101, 2, avenue Foch, 29609 Brest cedex, France. Electronic address: douraied.bensalem@chu-brest.fr.
authors.forename: Douraied
authors.initials: D
authors.lastname: Ben Salem
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056667:Biometric Identification / Q000379:methods*; D005260:Female; D005554:Forensic Medicine / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Computed tomography; Identification; Sphenoid sinus