Determination of Sex from Morphometry of Sternum Using Multidetector Computed Tomography in Central Indian Population

Abstract

Background: Autopsies often require determining the sex of unidentified corpses, particularly in cases of decomposition, mutilation, or mass disasters. Sternal bone measurements can be used in establishing the sex of unidentified corpses where the body is in advanced stages of putrefaction or in a mutilated condition.

Aim: This study focuses on the sternum, a robust bone aiding in anthropological sex and age determination, trying to provide precise data for sex identification in decomposed or mutilated bodies, and using digital imaging to eliminate subjectivity in manual autopsy measurements.

Materials and methods: It was a cross-sectional discriminant study done by analyzing 250 adult computed tomography (CT) scans, excluding those under 25 or over 80 and with sternal trauma or deformities. The study visually assessed normal thoracic skeletal anatomy in the CT chest. DICOM viewers obtained three-dimensional sternum images for measurements, and statistical analysis was done with SPSS software.

Results: Mean measurements, except the sternal index, were significantly higher in males. Mesosternal length showed the highest predictive power (females [73.4%] and males [76.2%]). Combining multiple parameters increased accuracy (females [75%], males [82.5%]).

Conclusion: This study thus concludes that sternal bone imaging is a valuable tool for sex determination. The seven parameters analyzed exhibit sexual dimorphism, with mesosternal length being the most accurate. These findings aid future sex determination in mass fatality incidents, explosions, or advanced decomposition. Importantly, this research provides specific data for the Indian population, addressing the need for diverse reference values.

Keywords: Computed tomography scan; forensic radiology; multidetector computed tomography; sex determination; sternum.

Figure 1

Three-dimensional reconstructed image of computed tomography chest showing parameters being studied

Figure 2

(a) Upper left: Mirror graph showing the distribution of manubrium length; (b) Upper right: Box plot showing a comparison of the distribution of mesosternal length in both sexes; (c) Middle left: Mirror graph showing the distribution of sternebrae 1 width; (d) Middle right: Receiver operating characteristics curve of sternebrae 2 width; (e) Lower left: Mirror graph showing the distribution of sternebrae 3 width; (f) Lower right: Box plot showing the comparison of the distribution of sternebrae 4 width in both sexes