Gender determination from diagnostic factors on anteroposterior pelvic radiographs

Stent deformations in the common iliac and iliofemoral veins as a result of hip flexion and extension

OBJECTIVE

In the present study, we characterized deformations of venous stents implanted into common iliac veins for nonthrombotic iliac vein lesions and iliofemoral veins for deep vein thrombosis due to hip movements commensurate with everyday activities such as walking, sitting, and stair climbing.

METHODS

Patients treated with iliofemoral venous stents were recruited from three centers and underwent imaging with two orthogonal two-dimensional projection radiographs. Stents in the common iliac veins and iliofemoral veins crossing the hip joint were imaged with the hip in 0°, 30°, 90° and -15°, 0°, and 30° positions, respectively. Using the radiographs, the three-dimensional geometries of the stents were constructed for each hip position, and the diametric and bending deformations between those positions were quantified.

RESULTS

Twelve patients were included, and the findings showed that the common iliac vein stents experienced approximately twofold more local diametric compression with 90° hip flexion compared with 30° flexion. Also, iliofemoral vein stents crossing the hip joint experienced significant bending with hip hyperextension (-15°) but not with hip flexion. In both anatomic locations, maximum local diametric and bending deformations were in proximity with each other.

CONCLUSIONS

Stents implanted in the common iliac and iliofemoral veins exhibit greater deformation during high hip flexion and hyperextension, respectively, and iliofemoral venous stents interact with the superior ramus of the pubis during hyperextension. These findings suggest that device fatigue could be influenced by the type and level of patient physical activity, in addition to anatomic positioning, opening up the potential benefit of activity modification and the use of a careful implantation strategy. The proximity of maximum diametric and bending deformations means that simultaneous multimodal deformations should be considered for device design and evaluation.

A comprehensive morphometric analysis of crista galli for sex determination with a novel morphological classification on computed tomography images

PURPOSE

This study aimed to examine the morphometry of the crista galli (CG) on paranasal sinus computed tomography (PNCT) images to develop a new approach of morphological classification with objective radiological criteria and to investigate the relationship of morphometric and morphological characteristics with gender.

METHODS

The height, width, and length of the CG were measured on the PNCT images of 533 subjects (266 males, 267 females). Based on the dimensions and the presence of the cavitary component of the CG, the CG was classified into three morphological types. The success of CG dimensions and new morphological classification of CG in the determination of gender was evaluated with ROC and Paired Logistic Regression analyses.

RESULTS

The morphometric cutoff values of the height, width, and length of the CG for the estimation of gender were determined as 15.15, 3.45, and 13.25 mm, respectively. CG length (accuracy 83.7%) showed more successful classification rate on gender determination as compared to height (accuracy: 81.4%), and width (accuracy 81.2%) of the CG. The presence of ossified type CG accurately identified the male sex at a rate of 88.7%, and teardrop type CG determined female sex at a rate of 82.9%. Tubular type CG identified male sex correctly at the rate of 65.8%.

CONCLUSION

The height, length, and width measurements of CG on PNCT images and the new morphological types recommended in this study can be used in the determination of gender with high accuracy rates.

Development of a fluoroscopically guided robotic assistant for instrument placement in pelvic trauma surgery

Purpose: A method for fluoroscopic guidance of a robotic assistant is presented for instrument placement in pelvic trauma surgery. The solution uses fluoroscopic images acquired in standard clinical workflow and helps avoid repeat fluoroscopy commonly performed during implant guidance. Approach: Images acquired from a mobile C-arm are used to perform 3D-2D registration of both the patient (via patient CT) and the robot (via CAD model of a surgical instrument attached to its end effector, e.g; a drill guide), guiding the robot to target trajectories defined in the patient CT. The proposed approach avoids C-arm gantry motion, instead manipulating the robot to acquire disparate views of the instrument. Phantom and cadaver studies were performed to determine operating parameters and assess the accuracy of the proposed approach in aligning a standard drill guide instrument. Results: The proposed approach achieved average drill guide tip placement accuracy of 1.57 ± 0.47    mm and angular alignment of 0.35 ± 0.32    deg in phantom studies. The errors remained within 2 mm and 1 deg in cadaver experiments, comparable to the margins of errors provided by surgical trackers (but operating without the need for external tracking). Conclusions: By operating at a fixed fluoroscopic perspective and eliminating the need for encoded C-arm gantry movement, the proposed approach simplifies and expedites the registration of image-guided robotic assistants and can be used with simple, non-calibrated, non-encoded, and non-isocentric C-arm systems to accurately guide a robotic device in a manner that is compatible with the surgical workflow.

Evaluation of Sexual Dimorphism with Mandibular Parameters by Digital Panoramic Radiography

Introduction:

Sex determination is the first step of personal identification in the field of forensics and is essential for reconstructive profiling. The skull appears to be the most reliable part of the skeleton, apart from the pelvis, in sex determination. Tooth and bone are used as a key tool for personal identification due to their high resistance to decomposition and degradation. The present study aimed to evaluate the sexual dimorphism with mandibular parameters by digital panoramic radiography.

Materials and Methods:

In this analytical-descriptive study, the mandibular parameters in 315 females and 217 males, including the ramus height, the coronoid height, the mental height, the mandible body height, the minimum width of the ramus, the distance between the right and left gonial angle, the distance between the right and left condyle and the distance between the right and left coronoid, were measured in the panoramic radiography via SCANORA software. Discriminant function and canonical regression methods were used to determine the predictability of mandibular parameters in sexual dimorphism. P < 0.05 was considered to be statistically significant.

Results:

All parameters were statistically significant between genders (P<0.05). The mean of all parameters, except the gonial angle, in males, was higher than that of the female. Percentage of correctly classified in discriminant function based on the central and right side and left side dimorphic parameters of the mandible is 82.5% and 82.9%, respectively.

Conclusion:

According to the present study, panoramic radiography can be considered as a valuable tool in sex determination (with an accuracy of 82.5%), and all parameters of mandible had sexual dimorphism and showed that they are reliable parameters with a total accuracy of 82.5% in the sexual dimorphism.

Sex estimation using subpubic angle from reconstructed three-dimensional computed tomography pelvic model in a contemporary Malaysian population

Research in forensic anthropology is recent in Malaysia due to limited access to documented skeletal collections. However, advanced imaging techniques provide virtual bone samples for use in morphometric studies to establish population-specific standards by virtual anthropology. This study examined sexual dimorphism in the subpubic angle using a three-dimensional computed tomography model of the pelvis, in a contemporary Malaysian population. The sample comprised multidetector computed tomography (MDCT) scans of 50 male and 50 female adults. Segmentation of the MDCT scans was performed using 3D Slicer, and four landmarks were acquired using Stratovan Checkpoint for the subpubic angle measurement. The technical error of measurement (TEM), relative TEM, and coefficient of reliability (R) exhibited high reliability in measurements. Results showed that the subpubic angle in males was 68.6°±7.6° and in females 87.4°±6.5°. The subpubic angle in females was significantly larger than in males (P<0.001). Inverse correlation was found between the subpubic angle and age, in both males (r=−0.449, P<0.01) and females (r=−0.385, P<0.01). The overall accuracy of sex estimation using the subpubic angle was 94% (P<0.001). The subpubic angle, with a demarcating point of 78.6°, showed a sensitivity and specificity of 94% in the classification of female individuals. In conclusion, sex estimation using the subpu bic angle is highly accurate, with a high degree of expected sensitivity and specificity in the Malaysian population.

Height estimation based on second cervical vertebra measured using three-dimensional computed tomographic scanning in Iranian adults

OBJECTIVES

The cervical vertebrae are more durable than other skeletal components, and therefore may be the only remnants of a dead body. The present study aims to investigate the role of several linear dimensions of the second cervical vertebrae measured by Three-Dimensional Computed Tomographic Scanning (3D CT Scan) in height estimation of Iranian adult population. In this cross-sectional study, height determination was performed by measuring 15 indexes of the second cervical vertebrae. Indexes were obtained by screening cervical CT scan of 66 patients (33 males and 33 females) aged ≥ 18 years at Rasoul Hospital. Chi square, T student and logistic regression tests were used for statistical analysis. The significance level was considered to be < 0.05.

RESULT

In the total population, among the indexes for the second cervical vertebrae, the Max height of the axis (AMA) (r = 0.470, P = 0.0001), Max length of the axis (CMA) (r = 0.320, P = 0.007), and Sagittal max body diameter (DSMC) (r = 0.281, P = 0.019) had a strong and positive correlation with height. The results of this study showed the accuracy of linear dimensions of cervical vertebrae in determining the body height of the Iranian adult population.

Reliability of palatal rugoscopy for sexual dimorphism in forensic dentistry: A systematic literature review and meta-analysis

OBJECTIVE

This study aimed to assess the validity of palatal rugoscopy for sexual dimorphism in the casework routine of forensic dentistry.

DESIGN

A systematic literature reviews was established following the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) and Cochrane guidelines. Six electronic databases were searched as the primary source of information. "Grey literature" was included to avoid selection and publication bias. As a secondary source of information, the reference lists of the eligible studies were also consulted to increase the search spectrum. Methodological quality and risk of bias were assessed with Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews. Statistic tests, namely the meta-analysis of diagnostic accuracy, Cochran Q test, and I2 test, were performed to verify the heterogeneity between the eligible studies.

RESULTS

The systematic search resulted in 263 studies, out of each 8 fulfilled the inclusion criteria. An additional eligible article was included after the search in reference lists. From the 9 studies that underwent qualitative data extraction, six were selected for quantitative analysis. The meta-analysis of grouped sex estimates showed sensitivity and specificity rates of 89% and 83%, respectively. The Area Under the Curve reached 0.93. High heterogeneity and important methodological limitations were detected among the studies.

CONCLUSION

Palatal rugoscopy seems to have discriminant power for sexual dimorphism. However, the limitations found specifically in each study and the strong heterogeneity across studies suggest that palatal rugoscopy lacks evidence-based confirmation for reliable application as a sole tool for sexual dimorphism in practice.