Usefulness of distal tibial epiphyseal line and calcaneus epiphyseal line combination in ankle MRİ images for forensic age estimation

Objective: The age limits of 12, 15, and 18 in our country are significant in terms of the legal system. In cases involving sexual abuse, child pornography, illegal immigration, marriage, and other issues, judicial authorities require forensic professionals to assess the age of the accused or victim. Radiological procedures are the most extensively utilized method in this regard. Because of the potential dangers of radiation exposure outside of clinical indications, new researches are focusing on non-ionizing and non-invasive technologies. The goal of this work was to estimate age using MRI scans of the ankle as a non-ionizing method, to see whether it was compatible with people's actual ages, to show its applicability in our region, and to develop a database. Materials and Methods: The magnetic resonance imaging scans of patients aged 7 to 26 who applied to Çukurova University Medical Faculty Balcalı Hospital and had ankle magnetic resonance imaging between January 2011 and December 2020 were retrospectively evaluated. Patients who were using steroids, getting chemotherapy or radiotherapy, or who had disorders affecting bone formation, bone malignancy, ankle joint fractures, surgical fixation, or bone marrow edema were all excluded from the study. A 6-stage staging method recommended by Lu et al. was applied to the distal tibial and calcaneal epiphyseal line ossification points by examining the ankle magnetic resonance images of a total of 331 patients, 197 male and 134 female. Images from a 1.5 T magnetic resonance imaging with a 3-4 mm slice thickness and sagittal section fast spin echo T1-weighted sequence were assessed in the study. Results: Stage 1 in both the distal tibial and calcaneal epiphyses was last seen under the age of 18 years old in both genders as a result of the study. Stage 2 distal tibial epiphyseal ossification in males was seen in almost all cases over 18 years of age (with the exception of one case aged 25.5 years), and stage 5 distal tibial epiphysis in both genders and calcaneal epiphyseal ossification in males were seen in almost all cases over 18 years of age. Stage 2 in distal tibial epiphysis ossification (excluding a case aged 9.9 years) and stage 3 and stage 4 in calcaneal epiphyseal ossification were observed in both genders at the age of 12 years and above. Conclusion: According to our findings, magnetic resonance imaging is a non-ionizing technology that can be used in conjunction with other radiological procedures to identify the age limits of 12 and 18 years. Additional multicenter, comparative, and prospective studies by experienced researchers are believed to be required in order to make the use of magnetic resonance imaging routine in age estimation.