Magnetic resonance imaging of the medial extremity of the clavicle in forensic bone age determination: a new four-minute approach

The use of 3T magnetic resonance imaging (MRI) of the clavicle in forensic bone age determination was prospectively examined and compared with plain radiography. Four MRI sequences and three radiographs of 121 healthy subjects between 11 and 30 were studied by two observers. The number of images assessable for bone age determination was lower for plain radiography (PA: 68.7%; oblique: 97.5%) compared with MRI (VIBE: 99.0%). Concerning the subjective level of difficulty to assess bone age, the observers found it easier to assess bone age on MRI than on radiography. The developmental stages of the clavicle, as used on plain radiography, were transferable to MRI. Especially the VIBE gradient echo sequence provided an excellent depiction of the growth cartilage and ossification centre with a slice thickness of 0.9 mm and only a 4-min acquisition time. When the developmental stages were assigned, less variability between the observers was seen on MRI, compared with plain radiography. We conclude that 3T MRI provides high resolution, cross-sectional images of the maturation of the clavicle without ionising radiation in a very short time, allowing more accurate determination of bone age than plain radiography.