Sex estimation by size and shape of foramen magnum based on CT imaging

Foramen magnum (FM) has a well-protected position, which makes it of particular interest in forensic research. The aim of the study is to assess the sex differences in size and shape of FM, develop discriminant functions and logistic regression models based on the FM measurements, compare the accuracy results of the measurements obtained through different measuring approaches, and establish the most reliable variables for sex estimation in Bulgarian adults. Head CT scans of 140 Bulgarian adults were used in the study. The segmentation of the skulls was performed in the software InVesalius. The length, breadth, circumference, and area were measured based on the 3D coordinates of definite landmarks and semi-landmarks. The circumference and area were calculated regarding the foramen as a 2D and 3D structure. Two additional variables (λ2 and λ3) corresponding to the least square errors along the length and breadth directions at the fitting of the 3D coordinates to a plane were examined for their sex discriminating ability. The FM shape was classified based on the values of the FM index. The significance of the sex differences was assessed. Discriminate function analysis and binary logistic regression were conducted. Significant sex differences were established in the FM size and shape. The eigenvalue λ3 is the best discriminating parameter applying discriminant function analysis. The acceptance of FM as a 2D or 3D structure does not provide substantial information for its sex discrimination. The measurements of FM do not offer sufficiently high predicting rates for sex estimation in the Bulgarian population.