Comparative study on developmental stages of the clavicle by postmortem MRI and CT imaging

ObjectivesThe developmental stages of the clavicles are important for forensic age estimation purposes in adolescents. This study compares the 4-stage system to evaluate the ossification of the medial end of the clavicle as visualized by magnetic resonance imaging (MRI) and computed tomography (CT). As several forensic institutes routinely perform CT scans, the large amount of available data may serve as reference sample for MRI in specific cases.Material and methodsThis prospective study included an MRI and CT scan of 47 autopsy cases performed prior to medico-legal autopsy (age range 12.9–27.5 years). All images were scored in blind trials using a 4-stage system by a trained observer.ResultsIntra-observer agreements were substantial within (MRI: K=0.685, CT: K=0.611) and between modalities (K=0.644, p<0.001). No systematic differences were found between stages as assessed by CT and MRI. The mean and minimum ages by each stage (2–4) were in accordance to previous published results. At younger than 18, no subjects were assessed as a stage 4.ConclusionAge estimation from the clavicle using either CT or MRI performs concordantly. In lack of MRI reference studies, CT data may be used.