Sex estimation by morphometric analysis of the intracranial volume and foramen magnum on three-dimensional volume rendering computed tomography

Yıl 2025, Cilt: 18 Sayı: 2, 7 - 7

Ayşe Kurtuluş Dereli , Ergin Sağtaş , Alper Akça , Hakan Abdullah Özgül , Hande Şenol , Kemalettin Acar

https://doi.org/10.31362/patd.1535671

Öz

Purpose: Identification of decomposed human bodies and bone remains is very important in medicolegal examinations. The cranium has an important place in sex estimation due to its dimorphic features. Recent studies in this field have used radiological methods. The present study aimed to examine sexual dimorphism through morphometric analysis of the intracranial volume and Foramen Magnum on Three-Dimensional (3D) Volume Rendering Computed Tomography (CT) images.
Materials and methods: For this purpose, 3D images were generated after the reconstruction of CT Angiography scans of 87 female and 107 male cases. The length, width, circumference, area, and intracranial volume of the foramen magnum were measured on these 3D images.
Results: All measurements except foramen magnum index were greater in males than in females (p<0.05). The single best sex-discriminatory measurement was intracranial volume, with an accuracy rate of 84.5%. The best sex-discriminatory parameter in foramen magnum measurements was the length of the foramen magnum, with a rate of 74.2%. Intracranial volume was positively correlated with foramen magnum parameters in males (p<0.05).
Conclusion: Three-dimensional volume rendering CT images showed sexual dimorphism in the intracranial volume and foramen magnum. The use of radiological methods in forensic investigations may allow for examinations of decomposed human bodies without the need for maceration procedures. It may also help create databases by examining population-specific differences in today's societies.

Anahtar Kelimeler

Volume rendering CT, 3D modeling, foramen magnum, intracranial volume, sex estimation

Etik Beyan

Ethical approval: Permission was obtained from Pamukkale University Non-Interventional Clinical Research Ethics Committee for the study (27.10.2020- E-60116787-020-3505). All procedures performed in studies were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Volume rendered bilgisayarlı tomografi görüntülerinde intrakranial hacim ve foramen magnum morfometrik analizinden cinsiyetin değerlendirilmesi

Öz

Amaç: Medikolegal incelemelerde çürümüş cesetlerde ve kemik kalıntılarında kimliklendirme çok önemlidir. Kranium dimorfik özelliklere sahip olduğu için cinsiyet tahmininde önemli yer tutar. Son zamanlarda bu alandaki araştırmalarda radyolojik yöntemlerin kullanıldığı görülmektedir. Bu çalışmada Volume Rendered Bilgisayarlı Tomografi 3B görüntülerinde intrakranial hacim ve Foramen Magnum morfometrik analizinden seksüel dimorfizmin araştırılması amaçlanmıştır.
Gereç ve yöntem: Bu amaçla 87 kadın ve 107 erkek olguya ait BT Anjiografi görüntülerinden rekonstrüksiyon sonrası üç boyutlu (3B) görüntüler elde edilmiştir. Elde edilen görüntülerde foramen magnum uzunluğu, genişliği, çevresi, alanı ve intrakranial hacim ölçülmüştür.
Bulgular: Foramen magnum indeksi dışındaki tüm ölçümlerin erkeklerde kadınlarda daha büyük olduğu görülmüştür (p<0,05). Cinsiyeti tek başına en iyi ayırt eden ölçüm %84,5 doğruluk oranı ile intrakranial hacimdi. Foramen magnum ölçümlerinde cinsiyeti en iyi ayırt eden parametre ise %74,2 oranı ile foramen magnum uzunluğuydu. İntrakraniyal hacim erkeklerde foramen magnum parametreleri ile pozitif bir korelasyon gösterdi (p<0,05).
Sonuç: Volume rendered BT 3B görüntülerinde intrakranial hacim ve foramen magnumda cinsel dimorfizm olduğu görülmüştür. Radyolojik yöntemlerin adli incelemelerde kullanılması çürümüş cesetlerde maserasyon işlemlerine gerek kalmadan incelemelerin yapılmasına olanak sağlayabilir. Ayrıca günümüz toplumlarındaki popülasyona özgü farklılıkların araştırılarak veri tabanlarının oluşturulmasına yardımcı olabilir.

Anahtar Kelimeler

Volume rendering BT, 3B modelleme, foramen magnum, intrakranial hacim, cinsiyet tahmini

Kaynakça

• 1. Saukko P, Knight B. Knight’s forensic pathology. 4th ed. London: CRC Press, 2016:95-132.
• 2. Krogman WM, Iscan MY. The human skeleton in forensic medicine. 2nd ed. Springfield IL USA: Charles C Thomas Publishers, 1986.
• 3. Krüger GC, L'Abbé EN, Stull KE, Kenyhercz MW. Sexual dimorphism in cranial morphology among modern South Africans. Int J Legal Med 2015;129:869-875. https://doi.org/10.1007/s00414-014-1111-0
• 4. Teixeria WR. Sex identification utilizing the size of foramen magnum. Am J Forensic Med Pathol 1982;3:203-206 https://doi.org/10.1097/00000433-198209000-00003
• 5. Günay Y, Altinkök M. The value of the size of foramen magnum in sex determination. J Clin Forensic Med 2000;7:147-149. https://doi.org/10.1054/jcfm.2000.0430
• 6. Gruber P, Henneberg M, Böni T, Rühli FJ. Variability of human foramen magnum size. Anat Rec (Hoboken) 2009;292:1713-1719 https://doi.org/10.1002/ar.21005
• 7. Catalina Herrera CJ. Study of the anatomic metric values of the foramen magnum and its relation to sex. Acta Anat (Basel) 1987;130:344-347. https://doi.org/10.1159/000146468
• 8. Acer N, Sahin B, Ekinci N, Ergür H, Basaloglu H. Relation between intracranial volume and the surface area of the foramen magnum. J Craniofac Surg 2006;17:326-330. https://doi.org/10.1097/00001665-200603000-00020
• 9. Onwuzu SWI, Idigo FU, Okeji MC. Assessment of the total intra-cranial volume of the Igbo population of Nigeria using computed tomography. Radiation Science and Technology 2017;3:8-12. https://doi.org/10.11648/j.rst.20170302.11
• 10. Acer N, Sahin B, Bas D, Ertekin T, Usanmaz M. Comparison of three methods for the estimation of total intracranial volume: stereologic, planimetric, and anthropometric approaches. Ann Plast Surg 2007;56:48-53. https://doi.org/10.1097/01.sap.0000250653.77090.97
• 11. Shepur MP, Magi M, Nanjundappa B, Havaldar PP, Gogi P, Saheb SH. Morphometric analysis of endocranial capacity. Int J Anat Res 2014;2:242-248.
• 12. Manjunath KY. Estimation of cranial volume an overview of methologies. J Anat Soc India 2002;51:85-91.
• 13. Manjunath KY. Estimation of cranial volume in dissecting room cadavers. J Anat Soc India 2002;51:168-172.
• 14. Breakey W, Knoops PGM, Borghi A, et al. Intracranial volume measurement: a systematic review and comparison of different techniques. J Craniofac Surg 2017;28:1746-1751. https://doi.org/10.1097/SCS.0000000000003929
• 15. Dereli AK, Zeybek V, Sagtas E, Senol H, Ozgul HA, Acar K. Sex determination with morphological characteristics of the skull by using 3D modeling techniques in computerized tomography. Forensic Sci Med Pathol 2018;14:450-459. https://doi.org/10.1007/s12024-018-0029-0
• 16. Lagrave`re MO, Major PW. Proposed reference point for 3-dimensional cephalometric analysis with cone-beam computerized tomography. Am J Orthod Dentofacial Orthop 2005;128:657-660. https://doi.org/10.1016/j.ajodo.2005.07.003
• 17. Franklin D, Cardini A, Flave A, Kuliukas A. Estimation of sex from cranial measurements in a Western Australian population. Forensic Sci Int 2013;229:158(e1-8). https://doi.org/10.1016/j.forsciint.2013.03.005
• 18. Ramsthaler F, Kettner M, Gehl A, Verhoff MA. Digital forensic osteology: morphological sexing of skeletal remains using volume-rendered cranial CT scans. Forensic Sci Int 2010;195:148-152. https://doi.org/10.1016/j.forsciint.2009.12.010
• 19. Cavalcanti MGP, Rocha SS, Vanier MW. Craniofacial measurements based on 3D-CT volume rendering: implications for clinical applications. Dentomaxillofacial Radiol 2004;33:170-176. https://doi.org/10.1259/dmfr/13603271
• 20. Franklin D, Cardini A, Flavel A, et al. Concordance of traditional osteometric and volume‑rendered MSCT interlandmark cranial measurements. Int J Legal Med 2013;127:505‑520. https://doi.org/10.1007/s00414-012-0772-9
• 21. Agarwal HK, Setia PS, Pandey S. Virtual determination of sex: estimating cut off value of digital metric traits of foramen magnum on three-dimensional computed tomography with receiver operating characteristic and logistic regression analysis. J Forensic Sci Med 2021;7:1-8. https://doi.org/10.4103/jfsm.jfsm_59_20
• 22. Abdel Karim RI, Housseini AM, Hashish RK. Adult sex estimation using three dimensional volume rendering multislice computed tomography of the foramen magnum and occipital condyles: a study in Egyptian population. Int J Advanced Res 2015;3:1212-1215.
• 23. François PM, Sandoz B, Laporte S, Decq P. Intra cranial volume quantification from 3D reconstruction based on CT-scan data. Comput Methods Biomech Biomed Engin 2017;20:81-82. https://doi.org/10.1080/10255842.2017.1382870
• 24. Isaza J, Dı´az CA, Bedoya JF, Monsalve T, Botella MC. Assessment of sex from endocranial cavity using volume-rendered CT scans in a sample from Medellín, Colombia. Forensic Sci Int 2014;234:186(e1-10). https://doi.org/10.1016/j.forsciint.2013.10.023
• 25. Akay G, Güngör K, Peker I. Morphometric analysis of the foramen magnum using cone beam computed tomography. Turk J Med Sci 2017;47:1715-1722. https://doi.org/10.3906/sag-1607-127
• 26. Uthman AT, Al Rawi NH, Al Timimi JF. Evaluation of foramen magnum in gender determination using helical CT scanning. Dentomaxillofac Radiol 2012;41:197-202. https://doi.org/10.1259/dmfr/21276789
• 27. Murshed KA, Çiçekcibaşi AE, Tuncer I. Morphometric evaluation of the foramen magnum and variations in its shape: a study on computerized tomographic images of normal adults. Turk J Med Sci 2003;33:301-306.
• 28. Toneva D, Nikolova S, Harizanov S, et al. Sex estimation by size and shape of foramen magnum based on CT imaging. Leg Med (Tokyo) 2018;35:50-60. https://doi.org/10.1016/j.legalmed.2018.09.009
• 29. Meral O, Toklu BB, Meydan R, Kaya A, Karadayi B, Acar T. Sex estimation from foramen magnum parameters in adult Turkish population: a computed tomography study. Leg Med (Tokyo) 2020;47:101775. https://doi.org/10.1016/j.legalmed.2020.101775
• 30. Chovalopoulou ME, Bertsatos A. Estimating sex of modern Greeks based on the foramen magnum region. J Anthropol 2017;1:1-7. https://doi.org/10.1155/2017/9129801
• 31. Gapert R, Black S, Last J. Sex determination from the foramen magnum: discriminant function analysis in an eighteenth and nineteenth century British sample. Int J Legal Med 2009;123:25-33. https://doi.org/10.1007/s00414-008-0256-0
• 32. Jain D, Jasuja OP, Nath S. Evaluation of foramen magnum in sex determination from human crania by using discriminant function analysis. El Med J 2014;2:89-92. https://doi.org/10.18035/emj.v2i2.82
• 33. Uysal S, Gokharman S, Kacar M, Tuncbilek I, Kosa U. Estimation of sex by 3D CT measurements of the foramen magnum. J Forensic Sci 2005;50:1310-1314.
• 34. Tambawala SS, Karjodkar FR, Sansare K, Prakash N, Dora AC. Sexual dimorphism of foramen magnum using Cone Beam Computed Tomography. J Forensic Leg Med 2016;44:29-34. https://doi.org/10.1016/j.jflm.2016.08.005
• 35. İlgüy D, İlgüy M, Ersan N, Dölekoğlu S, Fişekçioğlu E. Measurements of the foramen magnum and mandible in relation to sex using CBCT. J Forensic Sci 2014;59:601-605. https://doi.org/10.1111/1556-4029.12376
• 36. Bayrak S, Goller Bulut D. Assessment of foramen magnum and clivus for esimation of age and gender using cone-beam CT. Atatürk Univ Diş Hekimliği Fak Derg 2019;29:244-251. https://doi.org/10.17567/ataunidfd.482950
• 37. Mazonakis M, Karampekios S, Damilakis J, Voloudaki A, Gourtsoyiannis N. Stereological estimation of total intracranial volume on CT images. Eur Radiol 2004;14:1285-1290. https://doi.org/10.1007/s00330-004-2253-0
• 38. Rasidi MQZBM, Kumar SS. Sexual dimorphism from cranial capacity of adult south India skulls. Res J Pharm Tech 2016;9:1389-1392. https://doi.org/10.5958/0974-360X.2016.00267.5
• 39. Hwang Y, Lee KH, Choi BY, et al. Study on the Korean adult cranial capacity. J Korean Med Sci 1995;10:239-242. https://doi.org/10.3346/jkms.1995.10.4.239
• 40. Sahin B, Acer N, Sonmez OF, et al. Comparison of four methods for the estimation of intracranial volume: a gold standard study. Clin Anat 2007;20:766-773. https://doi.org/10.1002/ca.20520
• 41. Emirzeoğlu M, Şahin B, Uzun A, Bilgiç S. Evaluation of the volumetric relation between cranial cavity and orbits. J Med Sci 2011;31:297-299. https://doi.org/10.5336/medsci.2009-15635
• 42. Gapert R, Last J. P45: Endocranial capacity correlates with the size of the foramen magnum in human adult crania. J Anat 2004;205:542-543.
• 43. Shepur MP, Magi M, Nanjundappa B, Havaldar PP, Gogi P, Saheb SH. Correlation between endocranial capacity and size of foramen magnum with special reference to sex. Int J Anat Res 2014;2:273-278. https://www.ijmhr.org/ijar_articles_vol2_1/IJAR-2014-418.pdf