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1.
PLoS One ; 14(7): e0220242, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31344143

RESUMO

BACKGROUND: The assessment of bone age and skeletal maturity and its comparison to chronological age is an important task in the medical environment for the diagnosis of pediatric endocrinology, orthodontics and orthopedic disorders, and legal environment in what concerns if an individual is a minor or not when there is a lack of documents. Being a time-consuming activity that can be prone to inter- and intra-rater variability, the use of methods which can automate it, like Machine Learning techniques, is of value. OBJECTIVE: The goal of this paper is to present the state of the art evidence, trends and gaps in the research related to bone age assessment studies that make use of Machine Learning techniques. METHOD: A systematic literature review was carried out, starting with the writing of the protocol, followed by searches on three databases: Pubmed, Scopus and Web of Science to identify the relevant evidence related to bone age assessment using Machine Learning techniques. One round of backward snowballing was performed to find additional studies. A quality assessment was performed on the selected studies to check for bias and low quality studies, which were removed. Data was extracted from the included studies to build summary tables. Lastly, a meta-analysis was performed on the performances of the selected studies. RESULTS: 26 studies constituted the final set of included studies. Most of them proposed automatic systems for bone age assessment and investigated methods for bone age assessment based on hand and wrist radiographs. The samples used in the studies were mostly comprehensive or bordered the age of 18, and the data origin was in most of cases from United States and West Europe. Few studies explored ethnic differences. CONCLUSIONS: There is a clear focus of the research on bone age assessment methods based on radiographs whilst other types of medical imaging without radiation exposure (e.g. magnetic resonance imaging) are not much explored in the literature. Also, socioeconomic and other aspects that could influence in bone age were not addressed in the literature. Finally, studies that make use of more than one region of interest for bone age assessment are scarce.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Aprendizado de Máquina , Determinação da Idade pelo Esqueleto/instrumentação , Determinação da Idade pelo Esqueleto/tendências , Fatores Etários , Desenvolvimento Ósseo/fisiologia , Criança , Desenvolvimento Infantil/fisiologia , História do Século XX , História do Século XXI , Humanos , Aprendizado de Máquina/tendências , Exame Físico/métodos , Exame Físico/estatística & dados numéricos , Exame Físico/tendências
2.
Isr Med Assoc J ; 19(9): 533-538, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28971634

RESUMO

BACKGROUND: Bone maturation is currently assessed by subjective and automated radiography. OBJECTIVES: To evaluate the concordance and reproducibility of a quantitative ultrasound (QUS) based device versus X-ray based methods. METHODS: The study population comprised 150 children, 76 males, 4-17 years of age. X-ray scans were evaluated according to wrist, carpal and phalanx areas for bone age. QUS was performed by the the BAUS™ device (SonicBone, Rishon Lezion, Israel), using speed-of-sound (SOS) and distance attenuation factor (ATN) in similar areas. Data from 100 subjects were used to establish the device conversion equation, and 50 measurements were assigned to assess inter-modality agreement. RESULTS: BAUS showed high repeatability performance, 0.73% relative standard deviation for SOS and 3.5% for ATN. R2 for the conversion equation, including gender, SOS, and ATN, was 0.80 for all methods (P < 0.001). There was no significant bias in bone age assessments. CONCLUSIONS: Bone age assessment by SonicBone is comparable to the assessment by X-ray based methods.


Assuntos
Mãos/diagnóstico por imagem , Ultrassonografia/instrumentação , Absorciometria de Fóton , Adolescente , Determinação da Idade pelo Esqueleto/instrumentação , Densidade Óssea , Ossos do Carpo/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Humanos , Israel , Masculino , Radiografia/métodos , Reprodutibilidade dos Testes , Punho/diagnóstico por imagem
3.
Mil Med ; 182(9): e1769-e1772, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28885935

RESUMO

BACKGROUND: In our U.S. Department of Defense hospital system, pediatric endocrinology and radiology resources to evaluate bone age radiographs are limited. Our tertiary care center provides expert specialty support to remotely stationed beneficiaries at more than 30 Department of Defense medical facilities using a well-established, asynchronous, Health Insurance Portability and Accountability Act compliant system that allows for physician-to-physician teleconsultation. Up to 14% of these teleconsultations are for endocrinology assessment, many of which include bone age analysis. We sought to evaluate the feasibility of using an automated bone age analysis program using the file format most commonly provided to us, lossy JPEG image files saved at lower quality, to improve access to our consultation services. METHODS: All patients seen in the Tripler Army Medical Center pediatric endocrinology clinic, who were being evaluated for poor growth during the 2-month study period and who had a bone age film performed at Tripler Army Medical Center during that time, were eligible to have their deidentified bone age films analyzed. We imported lossy JPEG bone age image files from our hospital web viewer to BoneXpert, version 2.1, using a fully automated, custom built system that reconstructed each file's true resolution and then packaged the original image into a Digital Imaging and Communications in Medicine header. The original JPEG files were saved at 70% quality. Bone age readings were compared between our pediatric endocrinologists (ENDO), pediatric radiologists (RADS), and BoneXpert (BONE). Additionally, adult height prediction from ENDO and BONE were compared. FINDINGS: 35 bone age images were evaluated over a 2-month period. Most patients were being evaluated for idiopathic short stature or growth hormone deficiency. Analysis of variance showed no significant differences in mean bone age readings between the 3 groups (mean bone age reading = 9.0, 9.1, and 9.1 years for ENDO, RADS, and BONE, respectively, p = 0.827). Mean (SD) differences between physician and software bone age readings were -0.09 (0.89) years (ENDO) and -0.03 (1.01) years (RADS). Mean difference for adult height predictions was only -0.2 cm (p = 0.806). DISCUSSION: Automated analysis of lossy JPEG files of bone age images using the BoneXpert software appears to be feasible and accurate. Larger studies are needed to validate these results.


Assuntos
Determinação da Idade pelo Esqueleto/instrumentação , Tomografia Computadorizada por Raios X/normas , Adolescente , Determinação da Idade pelo Esqueleto/métodos , Análise de Variância , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Design de Software , Tomografia Computadorizada por Raios X/métodos , Estados Unidos
4.
Spine Deform ; 5(4): 225-230, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28622896

RESUMO

STUDY DESIGN: Cross-sectional. OBJECTIVE: To examine the relationships between spine morphology, spine flexibility, and idiopathic scoliosis. BACKGROUND: Girls have a higher incidence of clinically significant scoliosis than boys, along with smaller vertebrae and greater flexibility. Based on biomechanical modeling, we hypothesized that smaller vertebral width relative to intervertebral disc (IVD) height would be associated with both greater lateral flexibility of the spine and with idiopathic scoliosis. METHODS: Magnetic resonance imaging was used to measure IVD height, vertebral width, and paraspinous musculature in 22 girls with mild and moderate idiopathic scoliosis and 29 girls without scoliosis ages 9-13 years. Clinical measurement of maximum lateral bending was also performed in the girls without scoliosis. A simple biomechanical model was used to estimate bending angle from the ratio of IVD height to vertebral half-width for L1-L4. The average ratio (Ravg) and calculated total bending angle (αtot) for L1-L4 were compared to the clinical measurements of lateral bending flexibility in the control group. These measures were also compared between the scoliosis and control groups. RESULTS: There was a significant positive relationship between clinical flexibility and both Ravg (p = .041) and αtot (p = .042) adjusting for skeletal age, height, body mass index, and paraspinous muscle area as covariates. The ratio was significantly higher (Ravg = 0.45 vs. 0.38, p < .0001) and the bending angle was significantly greater (αtot = 107° vs. 89°, p < .0001) for girls with scoliosis compared with controls. CONCLUSION: These results suggest that differences in spine morphology and corresponding changes in spine flexibility may be related to idiopathic scoliosis. If these relationships can be corroborated in larger prospective studies, these easily measured morphologic traits may contribute to a better understanding of the etiology of idiopathic scoliosis and an improved ability to predict scoliosis progression. LEVEL OF EVIDENCE: Level III.


Assuntos
Fenômenos Biomecânicos/fisiologia , Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Amplitude de Movimento Articular/fisiologia , Escoliose/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Adolescente , Determinação da Idade pelo Esqueleto/instrumentação , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Incidência , Disco Intervertebral/patologia , Vértebras Lombares/anormalidades , Imageamento por Ressonância Magnética/métodos , Masculino , Escoliose/epidemiologia , Escoliose/fisiopatologia , Coluna Vertebral/anatomia & histologia
5.
Forensic Sci Int ; 266: 281-288, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27344264

RESUMO

Determination of skeletal development is a key pillar in forensic age estimation of living persons. Radiological assessment of hand bone age is widely used until the age of about 17-18 years, applying visual grading techniques to hand radiographs. This study investigated whether Greulich-Pyle (GP) and Tanner-Whitehouse (TW2) grading can be equally used for magnetic resonance imaging (MRI) data, which would offer the huge benefit of avoiding ionizing radiation. In 18 subjects aged between 7 and 17 years a radiograph and an MRI scan of the hand were performed. Epiphyseal ossification of hand bones was rated by two blinded radiologists with both GP and TW2. Correlation between hand MRIs and radiographs was analyzed by linear regression and inter-observer agreement was assessed. Correlation between age estimates from MRI and radiographs was high for both GP (r(2)=0.98) and TW2 (r(2)=0.93). MRI showed a tendency to estimate age slightly lower for 14-18 year-olds, which would be favorable regarding majority age determination in case this result could be reproduced using a currently not existing reference estimation method based on MRI data. Inter-observer agreement was similar for GP in radiographs and MRI, while for TW2, agreement in MRI was lower than in radiographs. In spite of limitations regarding sample size and recruited subjects, our results indicate that the use of GP and TW2 on MRI data offers the possibility of hand bone age estimation without the need for ionizing radiation.


Assuntos
Determinação da Idade pelo Esqueleto/instrumentação , Determinação da Idade pelo Esqueleto/normas , Ossos da Mão/diagnóstico por imagem , Imageamento por Ressonância Magnética , Humanos , Projetos Piloto
6.
Leg Med (Tokyo) ; 18: 13-9, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26832370

RESUMO

The spheno-occipital synchondrosis has a relatively late ossification in comparison with other cranial base synchondroses, which makes it a point of interest for forensic age determination studies. The purpose of the present study was to evaluate the reliability of spheno-occipital synchondrosis development in age determination in a Turkish population and to evaluate the reproducibility and reliability of cone beam computed tomography (CBCT) in an evaluation of the fusion stages of spheno-occipital synchondrosis. CBCT mid-sagittal images of 238 (90 males and 148 females) patients between the ages of 7 and 25, with a mean age of 15.45±0.26 and 16.43±0.37, respectively, were examined by three Oral and Maxillofacial Radiologists who evaluated the degree of synchondrosis fusion using a four-stage system. A reevaluation of 50 cases was conducted for intraobserver assessment. Multiple statistical analyses were used to assess the correlation between age and the fusion stage, to compare gender and age according to stages, and to evaluate the inter- and intraobserver agreement. The mean ages for complete fusion (Stage 3) were 18 and 20 for females and males, respectively. The interobserver agreement ranged between substantial and perfect, while the intraobserver agreement was substantial for all three observers. Based on these results, CBCT, when available, might be the method of choice for age estimation using the spheno-occipital synchondrosis fusion stages. Evaluating spheno-occipital synchondrosis has a value for age estimation around the age of 18 years, which affects the legal decisions in Turkey.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Osso Occipital/diagnóstico por imagem , Osso Esfenoide/diagnóstico por imagem , Adolescente , Adulto , Determinação da Idade pelo Esqueleto/instrumentação , Criança , Feminino , Antropologia Forense/instrumentação , Antropologia Forense/métodos , Humanos , Masculino , Variações Dependentes do Observador , Osso Occipital/crescimento & desenvolvimento , Reprodutibilidade dos Testes , Estudos Retrospectivos , Osso Esfenoide/crescimento & desenvolvimento , Estatísticas não Paramétricas , Turquia , Adulto Jovem
7.
Leg Med (Tokyo) ; 17(6): 560-8, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26162996

RESUMO

Estimation of age at death is an important part of physical and forensic anthropology. The aim of this study was to investigate whether bioelectrical impedance analysis (BIA) of long bones can be used in the field of forensic medicine as a method to estimate age at death. BIA is easy to use and allows repeat measurements to be taken over time, and the equipment is inexpensive and portable. Impedance values (Z values) in 378 long bones (humeri, radii, femora, tibiae) of 40 male (233 bones) and 26 female (145 bones) autopsy cadavers were measured using two wire electrodes (connected to an alternating current device and a measuring device) inserted into the metaphyses of long bones. Computed tomography of the greater trochanter of the femur was also analyzed to evaluate bone mineral density (BMD). The results showed that Z values could be used to estimate age in males, and with an age cut-off point of 50 years in females. When estimating age at death from femur and tibia in males by using BIA, it is not necessary to consider the length of subjects. And it was thought that Z values reflected BMD. Among the long bones, the tibia is the most suitable and easy to use for Z value measurement. Z value measurement is a useful method for quantitative evaluation of age at death that can be performed quickly with inexpensive, portable equipment.


Assuntos
Determinação da Idade pelo Esqueleto , Densidade Óssea , Impedância Elétrica , Adulto , Determinação da Idade pelo Esqueleto/instrumentação , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Antropologia Forense/métodos , Medicina Legal , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
8.
Zhongguo Yi Liao Qi Xie Za Zhi ; 38(4): 264-6, 2014 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-25330606

RESUMO

OBJECTIVE: The device of a bone age film of analysis and process was designed, can calculate the expected patient's height and identify growth level and development. METHODS: Select the DR bone age of 100 children of 6-13 years old, used semi Lagrange algorithm of target region of interest on bone age piece (ROI) for image analysis, compared with 2 pediatric endocrinologists (A, B) who used TW3 artificial to judge bone age (two methods were detected 2 times), and report the results. RESULTS: Bone age assessment process, forecast error of bone age reduced to 0.12 years. CONCLUSIONS: This device can quickly calculate the expected patient's height and identify his growth level, improve the speed and accuracy of bone age assessment, especially in the poor medical conditions in rural and remote areas.


Assuntos
Determinação da Idade pelo Esqueleto/instrumentação , Desenho de Equipamento , Adolescente , Criança , Humanos
9.
Leg Med (Tokyo) ; 15(5): 264-8, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23541874

RESUMO

Three dimensional pubic bone images were analyzed to quantify some age-dependent morphological changes of the symphyseal faces of contemporary Japanese residents. The images were synthesized from 145 bone specimens with 3D measuring device. Phases of Suchey-Brooks system were determined on the 3D pubic symphyseal images without discrepancy from those carried out on the real bones because of the high fidelity. Subsequently, mean curvatures of the pubic symphyseal faces to examine concavo-convex condition of the surfaces were analyzed on the 3D images. Average values of absolute mean curvatures of phase 1 and 2 groups were higher than those of phase 3-6 ones, whereas the values were approximately constant over phase 3 presumably reflecting the inactivation of pubic faces over phase 3. Ratio of the concave areas increased gradually with progressing phase or age classes, although convex areas were predominant in every phase.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Povo Asiático , Antropologia Forense/métodos , Osso Púbico/anatomia & histologia , Sínfise Pubiana/anatomia & histologia , Adolescente , Adulto , Determinação da Idade pelo Esqueleto/instrumentação , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Antropologia Forense/instrumentação , Humanos , Imageamento Tridimensional/instrumentação , Imageamento Tridimensional/métodos , Japão , Masculino , Pessoa de Meia-Idade , Osso Púbico/diagnóstico por imagem , Sínfise Pubiana/diagnóstico por imagem , Adulto Jovem
10.
Magn Reson Med ; 69(6): 1697-702, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22851444

RESUMO

MRI may be a noninvasive and alternative tool for skeletal age assessment in children, although few studies have reported on this topic. In this article, skeletal age was assessed over a wide range of ages using an open, compact MRI optimized for the imaging of a child's hand and wrist, and its validity was evaluated. MR images and their three-dimensional segmentation visualized detailed skeletal features of each bone in the hand and wrist. Skeletal age was then independently scored from the MR images by two raters, according to the Tanner-Whitehouse Japan system. The skeletal age assessed by MR rating demonstrated a strong positive correlation with chronological age. The intrarater and inter-rater reproducibilities were significantly high. These results demonstrate the validity and reliability of skeletal age assessment using MRI.


Assuntos
Determinação da Idade pelo Esqueleto/instrumentação , Envelhecimento/fisiologia , Ossos da Mão/anatomia & histologia , Ossos da Mão/crescimento & desenvolvimento , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Adolescente , Determinação da Idade pelo Esqueleto/métodos , Envelhecimento/patologia , Criança , Pré-Escolar , Desenho de Equipamento , Análise de Falha de Equipamento , Feminino , Humanos , Masculino , Miniaturização , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
11.
Sud Med Ekspert ; 55(1): 49-51, 2012.
Artigo em Russo | MEDLINE | ID: mdl-22567958

RESUMO

The principal characteristics of the investigations concerning estimation of the human age are presented. The new high-precision methods for the microosteometric determination of the biological age of man have been developed. The methodological basis for the application of microosteomeric data to the computer-assisted analysis of the images has been created. Taken together, the results of the present study guarantee the high accuracy of the measurements, save labour time, and expand the possibilities for the documentation and control of the experts' work.


Assuntos
Determinação da Idade pelo Esqueleto , Prova Pericial , Interpretação de Imagem Assistida por Computador/métodos , Determinação da Idade pelo Esqueleto/instrumentação , Determinação da Idade pelo Esqueleto/métodos , Documentação/métodos , Documentação/normas , Prova Pericial/métodos , Prova Pericial/normas , Antropologia Forense/métodos , Antropologia Forense/normas , Humanos , Controle de Qualidade , Fatores de Tempo
12.
An. pediatr. (2003, Ed. impr.) ; 76(4): 199-213, abr. 2012. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-101350

RESUMO

Introducción: En este trabajo se presenta unos nuevos métodos numéricos a partir de los índices metacarpofalángico y carpiano para el cálculo de la edad ósea, así como poder predecir la talla adulta por medio de ecuaciones multiregresión. Material y métodos: La casuística longitudinal comprende a 160 niños zaragozanos sanos de ambos sexos, con edades comprendidas desde los 6meses hasta los 20años, estudiados anualmente, incluido el estudio radiológico. Para la labor estadística se ha utilizado el paquete estadístico «Statistix», así como el programa Excel. Resultados: Los nuevos índices se encuentran íntimamente correlacionados con la edad cronológica, dando por ello lugar a ecuaciones predictivas para el cálculo de la edad ósea de niños hasta 20 años, presentándose además ecuaciones propias hasta los cuatro, a efectos de poder afinar más el diagnóstico a estas cortas edades. Las edades óseas calculadas pueden ser llevadas tanto a tablas numéricas de desviación típica, como a una figura de equivalencias que nos dan el diagnóstico osificativo directamente. Las ecuaciones predictivas de talla adulta permiten una estimación fiable de la talla futura del niño a estudio. Estas estimaciones analizadas por el test de Student no han dado diferencias significativas respecto a la talla adulta que los niños de la casuística al final alcanzaron. Los resultados pueden obtenerse con una calculadora o a través de un programa informático a disposición gratuita del lector. Conclusiones: Son presentadas por vez primera, por métodos propios no foráneos, estándares de edad ósea, así como ecuaciones de predicción de talla adulta para el estudio de niños. Se invita al clínico a utilizar estos métodos metacarpofalángico y carpiano a fin de conseguir la experiencia necesaria para su idónea aplicación en población sana y con diversa patología(AU)


Introduction: This work presents new numerical methods from the meta-carpal-phalangeal and carpal indexes, for calculating bone age. In addition, these new methods enable the adult height to be predicted using multiple regression equations. Materials and Methods: The longitudinal case series studied included 160 healthy children from Zaragoza, of both genders, aged between 6months and 20 years, and studied annually, including the radiological study. For the statistical analysis the statistical package "Statistix", as well as the Excel program, was used. Results: The new indexes are closely co-related to the chronological age, thus leading to predictive equations for the calculation of the bone age of children up to 20 years of age. In addition, it presents particular equations for up to 4years of age, in order to optimise the diagnosis at these early ages. The resulting bones ages can be applied to numerical standard deviation tables, as well as to an equivalences chart, which directly gives us the ossification diagnosis. The predictive equations of adult height allow a reliable forecast of the future height of the studied child. These forecasts, analysed by the Student test did not show significant differences as regards the adult height that children of the case series finally achieved. The results can be obtained with a pocket calculator or through free software available for the reader. Conclusions: For the first time, and using a centre-developed and non-foreign methods, bones age standards and adult height predictive equations for the study of children, are presented. We invite the practitioner to use these meta-carpal-phalangeal and carpal methods in order to achieve the necessary experience to apply it to a healthy population and those with different disorders(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Peso-Idade/fisiologia , Determinação da Idade pelo Esqueleto/instrumentação , Determinação da Idade pelo Esqueleto/métodos , Determinação da Idade pelo Esqueleto , Metacarpo/fisiologia , Ossos Metacarpais/fisiologia , Peso-Estatura/fisiologia , Determinação da Idade pelo Esqueleto/tendências , Fatores Socioeconômicos , Indicadores Econômicos , Metacarpo , Ossos Metacarpais
13.
Appl Spectrosc ; 65(10): 1193-6, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21986080

RESUMO

We determined calcium-to-fluorine (Ca/F) signal ratios at the surface and in the depth dimension in approximately 6000-year-old sheep and cattle bones using Ca I 671.8 and F I 685.6 emission lines. Because the bones had been previously analyzed for collagen preservation quality by measurement of C/N ratios at the Oxford Radiocarbon Accelerator Unit, we were able to examine the correlation between our ratios and quality of preservation. In the bones analyzed in this experiment, the Ca I 671.8/F I 685.6 ratio was generally lower and decreased with successive laser pulses into poorly preserved bones while the ratio was generally higher and increased with successive laser pulses into well-preserved bones. After 210 successive pulses, a discriminator value for this ratio (5.70) could be used to distinguish well-preserved and poorly preserved bones regardless of species.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Arqueologia/métodos , Osso e Ossos/química , Cálcio/análise , Flúor/análise , Análise Espectral/métodos , Determinação da Idade pelo Esqueleto/instrumentação , Animais , Arqueologia/normas , Bovinos , Desenho de Equipamento , Lasers de Estado Sólido , Preservação Biológica/normas , Análise de Componente Principal , Ovinos , Análise Espectral/instrumentação
14.
Am J Hum Biol ; 23(3): 381-91, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21387459

RESUMO

OBJECTIVES: The occurrence of transverse radiopaque lines in long bones-Harris lines (HLs)-is correlated with episodes of temporary arrest of longitudinal growth and has been used as an indicator of health and nutritional status of modern and historical populations. However, the interpretation of HLs as a stress indicator remains debatable. The aim of this article is to evaluate the perspectives and the limitations of HLs analyses and to examine their reliability as a stress indicator. METHODS: The study was conducted on 241 tibiae from a medieval Swiss skeletal material and was carried out using a standardized, semiautomated HL detection and analysis tool developed by the authors. We compared four different age-at-formation estimation methods and analyzed the correlation of HL occurrence to life expectancy, mean-age-at-death, stature, tibia length, and metabolic disorders as expressed by linear enamel hypoplasia and hypothyroidism. RESULTS: The evaluation of the age-at-formation estimation methods showed statistical significant differences. Therefore, a mathematical framework for the conversion between the methods has been developed. Remodeling had eliminated about half of the HLs formed during adolescence, and a further half of the remaining ones during early adulthood, whereas no association between the aforementioned conditions and HL prevalence could be determined. The peaks of high HL frequency among various populations were found to parallel normal growth spurts and growth hormone secretion. CONCLUSIONS: We suggest a reconsideration of HLs as more of a result of normal growth and growth spurts, rather than a pure outcome of nutritional or pathologic stress.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Doenças Ósseas/epidemiologia , Hipoplasia do Esmalte Dentário/epidemiologia , Hipotireoidismo/epidemiologia , Tíbia/anatomia & histologia , Tíbia/crescimento & desenvolvimento , Adolescente , Adulto , Determinação da Idade pelo Esqueleto/instrumentação , Idoso , Estatura , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/etiologia , Doenças Ósseas/mortalidade , Criança , Pré-Escolar , Comorbidade , Feminino , História Medieval , Humanos , Processamento de Imagem Assistida por Computador/instrumentação , Processamento de Imagem Assistida por Computador/métodos , Lactente , Masculino , Pessoa de Meia-Idade , Paleopatologia , Prevalência , Suíça , Tíbia/diagnóstico por imagem , Tíbia/patologia , Adulto Jovem
15.
Forensic Sci Med Pathol ; 7(2): 148-54, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21057985

RESUMO

This study was designed in order to assess the suitability of clavicular development in discriminating whether or not an individual has reached the age of 18 years. The development of the medial clavicular epiphysis was examined in an Australian population using computed tomography as the imaging modality. The sample consisted of individuals who were admitted to the Victorian Institute of Forensic Medicine, Melbourne, Australia, for the purposes of medico-legal death investigation. Comparisons were made with similar studies conducted on different populations in other countries, which revealed that the Australian population reaches maturity earlier, and the level of left/right asymmetry is higher than in other studies. The high degree of variation in fusion times is discussed, and the consequent effect upon the ability to use this epiphysis as a tool for determining if an individual has reached the age of 18 years is analysed. If an individual in this population has completely fused clavicles at stage 5, then for males they will be at least 18 years of age, with a 99% certainty of being at least 21, and for females they will be at least 20 years old. If at stage three then an individual of either sex will be at least 17 years of age.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Clavícula/anatomia & histologia , Epífises/anatomia & histologia , Antropologia Forense/métodos , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Determinação da Idade pelo Esqueleto/instrumentação , Austrália , Clavícula/diagnóstico por imagem , Clavícula/crescimento & desenvolvimento , Epífises/diagnóstico por imagem , Epífises/crescimento & desenvolvimento , Feminino , Antropologia Forense/instrumentação , Humanos , Masculino , Adulto Jovem
16.
J Forensic Leg Med ; 17(6): 304-8, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20650417

RESUMO

OBJECTIVE: To examine the closure degree of spheno-occipital synchondrosis and its relationship with chronological age. MATERIALS AND METHODS: Cross-sectional analysis of the closure degree of spheno-occipital suture was done through direct inspection of 376 autopsies from both sexes whose ages ranged between 8 and 26 years in Legal Medicine Organization of Tehran, Iran from 1st of July 2007 to 1st of July 2009. The correlation between the degree of closure and chronological age was investigated. RESULTS: Mean ages of open, semi-closed and closed sutures were 12.27, 16.12 and 21.17 years in males, and 9.04, 12.38 and 19.44 in females, respectively. Seemingly, their difference was significant (p < 0.001). Partial fusion (semi-closed) was seen at the age of 12 in both sexes while complete fusion (closed) was seen at 15 year olds or above in males and 12 year olds or above in females. Spearman's correlation ratio coefficient showed a linear correlation between age and suture situation in both sexes (rho = 0.788, P < 0.001 in males and r = 0.645, P < 0.001 in females). CONCLUSION: The study showed that the closure degree of spheno-occipital suture can be used as a good indicator for age estimation in both sexes. Cadavers can be correctly grouped above or below 16 years old with sensitivity of 79.82% and specificity of 89.47% in males and above or below 13 years old with sensitivity of 100.00% and specificity of 81.58% in females.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Antropologia Forense/métodos , Osso Occipital/anatomia & histologia , Mudanças Depois da Morte , Osso Esfenoide/anatomia & histologia , Adulto , Determinação da Idade pelo Esqueleto/instrumentação , Distribuição por Idade , Fatores Etários , Idoso , Análise de Variância , Animais , Autopsia/métodos , Cadáver , Técnicas de Laboratório Clínico , Feminino , Antropologia Forense/instrumentação , Humanos , Modelos Lineares , Masculino , Sensibilidade e Especificidade , Base do Crânio/anatomia & histologia , Estatísticas não Paramétricas , Adulto Jovem
17.
J Clin Endocrinol Metab ; 94(7): 2239-44, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19401365

RESUMO

CONTEXT: Bone age rating is associated with a considerable rater variability, which limits its usefulness in modern pediatric endocrinology. An automated computerized method would theoretically solve this problem but has been surprisingly difficult to establish. EVIDENCE ACQUISITION: We review the development of automated bone age assessment and describe how the conceptual understanding of bone age rating shifted from a rule-based theory to a more intuitive and experience-based approach. The role of the CASAS system from 1992 is described. The BoneXpert system from 2008 employs deformable models of each bone to locate the bones and extracts the component of the bone appearance related to maturity in a holistic, statistical manner. Two clinical studies have been published on its accuracy, defined as the root mean square deviation from manual rating. Other studies addressed the precision of the method, defined as its ability to give the same result on a repeated x-ray, expressed as the sd on a single measurement. EVIDENCE SYNTHESIS: The accuracy of the automated bone age determination was 0.71-0.72 yr, and the precision was 0.17-0.18 yr. More than 98.6% of the images could be analyzed. The system was validated on children with various diagnoses of short stature in the bone age range 2.5-17 yr for boys and 2-15 yr for girls. CONCLUSION: The reviewed validation studies suggest that this automated bone age determination system has adequate accuracy, precision, and efficiency to be clinically useful.


Assuntos
Determinação da Idade pelo Esqueleto/instrumentação , Determinação da Idade pelo Esqueleto/métodos , Automação/métodos , Determinação da Idade pelo Esqueleto/normas , Algoritmos , Humanos , Reconhecimento Automatizado de Padrão/métodos , Reprodutibilidade dos Testes , Projetos de Pesquisa
18.
Pediatr Radiol ; 39(6): 598-607, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19333590

RESUMO

BACKGROUND: Bone age (BA) rating is time consuming and highly rater dependent. OBJECTIVE: To adjust the fully automated BoneXpert method to agree with the manual Greulich and Pyle BA (GP BA) ratings of five raters and to validate the accuracy for short children. MATERIALS AND METHODS: A total of 1,097 left hand radiographs from 188 children with short stature, including growth hormone deficiency (44%) and Turner syndrome (29%) were evaluated. RESULTS: BoneXpert rejected 14 of the 1,097 radiographs, and deviated by more than 1.9 years from the operator BA for 27 radiographs. These were rerated blindly by four operators. Of the 27 new ratings, 26 were within 1.9 years of the automatic BA values. The root mean square deviation between manual and automatic rating was 0.72 years (95% CI 0.69-0.75). CONCLUSION: BoneXpert's ability to process 99% of images automatically without errors, and to obtain good agreement with an operator suggests that the method is efficient and reliable for short children.


Assuntos
Determinação da Idade pelo Esqueleto/instrumentação , Determinação da Idade pelo Esqueleto/métodos , Algoritmos , Transtornos do Crescimento/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Países Baixos/epidemiologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
19.
Pediatr Radiol ; 39(6): 591-7, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19125243

RESUMO

BACKGROUND: Bone age (BA) assessment is a routine procedure in paediatric radiology, for which the Greulich and Pyle (GP) atlas is mostly used. There is rater variability, but the advent of automatic BA determination eliminates this. OBJECTIVE: To validate the BoneXpert method for automatic determination of skeletal maturity of healthy children against manual GP BA ratings. MATERIALS AND METHODS: Two observers determined GP BA with knowledge of the chronological age (CA). A total of 226 boys with a BA of 3-17 years and 179 girls with a BA of 3-15 years were included in the study. BoneXpert's estimate of GP BA was calibrated to agree on average with the manual ratings based on several studies, including the present study. RESULTS: Seven subjects showed a deviation between manual and automatic BA in excess of 1.9 years. They were re-rated blindly by two raters. After correcting these seven ratings, the root mean square error between manual and automatic rating in the 405 subjects was 0.71 years (range 0.66-0.76 years, 95% CI). BoneXpert's GP BA is on average 0.28 and 0.20 years behind the CA for boys and girls, respectively. CONCLUSION: BoneXpert is a robust method for automatic determination of BA.


Assuntos
Determinação da Idade pelo Esqueleto/instrumentação , Determinação da Idade pelo Esqueleto/métodos , Algoritmos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Países Baixos/epidemiologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
20.
Cuad. med. forense ; 14(53/54): 234-249, jul.-oct. 2008. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-61330

RESUMO

La correlación entre la reducción de la cavidadcoronal pulpar y la edad cronológica ha sido estudiada enuna muestra de 846 dientes intactos procedentes de 433individuos de sexo y edad conocidos. La radiografía panorámicaha sido utilizada para medir el largo (mm) de lacorona (CL=coronal length) y el largo (mm) de la cavidadcoronal pulpar. El índice dentario “Tooth coronal index”(TCI) según Ikeda et al. (1985) ha sido calculado por cadadiente para determinar la edad real del individuo con elmétodo de la regresión. Los coeficientes de regresiónvarían de -0.92 (molares, muestra total, lado derecho) a-0.87 (molares femeninos) con un S. E. de estimación de5.88 a 6.66 años. Las correlaciones son más altas en losvarones respecto a las mujeres. Las ecuaciones obtenidaslograron estimar la edad en una muestra de 100 dientes(no utilizados en la regresión) con un error de ± 5 añosen el 81.4% de los casos por los molares masculinos. Elestudio ilustra el valor potencial de un método que puedeser utilizado para estimar la edad en individuos vivos ymaterial esquelético de edad desconocida(AU)


The correlation between the reduction of thecoronal pulp cavity and the chronological age wasexamined in a sample of 846 intact teeth from 433individuals of known age and sex. Panoramic (rotational)radiography was used to measure the length (mm) of thetooth crown (CL=coronal length) and the length (mm) ofthe coronal pulp cavity (CPCL=coronal pulp cavity length).The tooth-coronal index (TCI) after Ikeda et al. (1985) wascomputed for each tooth and regressed on the real age ofthe sample. The correlation coefficients ranged from -0.92(molars, combined sample, right side) to -0.87 (femalemolars), with a S.E. of the estimate ranging from 5.88 to6.66 years. Correlations were slightly higher in males thanfemales. The obtained equations allowed estimation of agein a sample of 100 teeth of both sexes (not used for theregression) with an error of ± 5 years in 81.4% of casesfor the male molars. This study shows the potential valueof a little-known aging method, which can be easily used toestimate age both in living individuals and skeletal materialof unknown age in a forensic context(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Odontologia Legal/métodos , Odontologia Legal/normas , Odontologia Legal/tendências , Radiografia/instrumentação , Radiografia/tendências , Determinação da Idade pelo Esqueleto/classificação , Determinação da Idade pelo Esqueleto/instrumentação , Determinação da Idade pelo Esqueleto/métodos , Determinação da Idade pelos Dentes/métodos , Odontologia Legal/classificação , Odontologia Legal/ética , Odontologia Legal/instrumentação , Cronologia como Assunto , Tecnologia Radiológica/métodos , Determinação da Idade pelo Esqueleto/ética , Determinação da Idade pelo Esqueleto/normas , Determinação da Idade pelo Esqueleto
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