Evaluation of the morphological characteristic and sex differences of sternum by multi-detector computed tomography
Abstract
Background: Sternum is one of the skeleton parts which have frequently congenital anomalies and variations are commonly used by researchers in determining sex. We evaluated the morphological characteristics and sex-related changes of the sternum in adult individuals using multidetector computed tomography in
our study.
Materials and methods: Two hundred adults (103 female and 97 male) aged between 18 and 87 years were evaluated. Utilising the morphological characteristics of the sternum based on the multislice images; length, width and the thickness of manubrium, length, width and the thickness of corpus sterni, total length of sternum, sternal angle, sternal index (SI), length of the xiphoid process, the thickness of xiphoid process, the number of indents of xiphoid process were measured and a total of 20 parameters were evaluated by adding age, height
and weight to these variables.
Results: The mean length of the manubrium, the length of corpus sterni, the length of total sternum, SI, sternal angle were found in females 46.7 ± 5.1, 86.6 ± 9.7, 133.1 ± 1.1, 54.47 ± 10.0 and 163.75 ± 5.79; in males 51.2 ± 6,102.4 ± 13.3, 154.1 ± 13.1, 50.11 ± 10.02 and 162.21 ± 6.17, respectively. We found that Hyrtl’s Law and SI did not provide adequate accuracy for sex determination in our patients. It has been detected that the length of the manubrium alone is not helpful for individual samples. Total length of the sternum was found to be
more reliable than the length of the manubrium and the length of corpus sterni. We determined sternal cleft and sternal foramen as 0.5% and 3.5%, respectively.
Conclusions: We suggest that the morphometric standards cannot be universally applied and can demonstrate individual differences. The standard rules must be implemented for every population.
Keywords: sternummorphometric analysissexsternal variationsmultidetector computed tomography
References
- Akin K, Kosehan D, Topcu A, et al. Anatomic evaluation of the xiphoid process with 64-row multidetector computed tomography. Skeletal Radiol. 2011; 40(4): 447–452.
- Aktan ZA, Savaş R. Anatomic and HRCT demonstration of midline sternal foramen. Tr J Med Sciences. 1998; 28: 511–514.
- Ashley GT. The human sternum: the influence of sex and age on its measurements. J Forensic Med. 1956; 3: 27–43.
- Babinski MA, de Lemos L, Babinski MSD, et al. Frequency of sternal foramen evaluated by MDCT: a minor variation of great relevance. Surg Radiol Anat. 2015; 37(3): 287–291.
- Babinski M, Rafael F, Steil A, et al. High prevalence of sternal foramen: quantitative, anatomical analysis and its clinical implications in acupuncture practice. Int J Morphol. 2012; 30(3): 1042–1049.
- Bayaroğulları H, Yengil E, Davran R, et al. Evaluation of the postnatal development of the sternum and sternal variations using multidetector CT. Diagn Interv Radiol. 2014; 20(1): 82–89.
- Bongiovanni R, Spradley MK. Estimating sex of the human skeleton based on metrics of the sternum. Forensic Sci Int. 2012; 219(1-3): 290.e1–290.e7.
- Cooper PD, Stewart JH, McCormick WF. Development and morphology of the sternal foramen. Am J Forensic Med Pathol. 1988; 9(4): 342–347.
- Dahiphale VP, Baheete BH, Kamkhedkar SG. Sexing the human sternum in Marathwada region. J Anat Soc India. 2002; 5: 162–167.
- Duraikannu C, Noronha OV, Sundarrajan P. MDCT evaluation of sternal variations: Pictorial essay. Indian J Radiol Imaging. 2016; 26(2): 185–194.
- Dwight T. Sternum as an index of sex, height, and age. J Anat Physiol. 1890; 24(Pt 4): 527–535.
- Dwight T. The sternum as an index of sex and age. J Anat Physiol. 1881; 15(Pt 3): 327–330.
- Fokin AA. Cleft sternum and sternal foramen. Chest Surg Clin N Am. 2000; 10(2): 261–276.
- Gkantsinikoudis N, Chaniotakis C, Gkasdaris G, et al. Morphological approach of the sternal foramen: an anatomic study and a short review of the literature. Folia Morphol. 2017; 76(3): 484–490.
- Hunnargi SA, Menezes RG, Kanchan T, et al. Sexual dimorphism of the human sternum in a Maharashtrian population of India: a morphometric analysis. Leg Med. 2008; 10(1): 6–10.
- Hyrtl J. Handbuch der topographischen anatomic percentage. Vienna: Wilhelm Braumuller. 1893; 1S: 348.
- Işcan MY. Osteometric analysis of sexual dimorphism in the sternal end of the rib. J Forensic Sci. 1985; 30(4): 1090–1099.
- Jit I, Jhingan V, Kulkarni M. Sexing the human sternum. Am J Phys Anthropol. 1980; 53(2): 217–224.
- Moore MK, Stewart JH, McCormick WF. Anomalies of the human chest plate area. Radiographic findings in a large autopsy population. Am J Forensic Med Pathol. 1988; 9(4): 348–354.
- O'Neal ML, Dwornik JJ, Ganey TM, et al. Postnatal development of the human sternum. J Pediatr Orthop. 1998; 18(3): 398–405.
- Osunwoke EA, Gwunireama IU, Orish CN, et al. A study of sexual dimorphism of the human sternum in the southern Nigerian population. J Appl Biosci. 2010; 26: 1636–1639.
- Paterson AM. The human sternum. Williams and Norgate, London: University Press of Liverpool. 1904; pp 36-37 and 77.
- Pevenage P, De Ma, Muylle K, et al. Sternal foramen simulating osteolytic lesion on scintigraphy and SPET imaging. Ann Nucl Med Sci. 2002; 15: 227–230.
- Ramadan SU, Türkmen N, Dolgun NA, et al. Sex determination from measurements of the sternum and fourth rib using multislice computed tomography of the chest. Forensic Sci Int. 2010; 197(1-3): 120.e1–120.e5.
- Rother P, Hunger H, Liebert U, et al. [Sex differences in the human sternum]. Gegenbaurs Morphol Jahrb. 1975; 121(1): 29–37.
- Selthofer R, Nikolić V, Mrcela T, et al. Morphometric analysis of the sternum. Coll Antropol. 2006; 30(1): 43–47.
- Teige K. [Morphometric studies of x-rays of the sternum]. Z Rechtsmed. 1983; 90(3): 199–204.
- Wenzel J (1788), cited by Ashley GT. A comparison of human and anthropoid mesosterna. Am J Phys Anthropol. 1956;3: 449-65, indexed in Pubmed: 13381831.
- Yamamura Y, Esper RS, Cricenti SV. Forames Esternais e Os Pontos de Acupuntura VC-17 (Shanzhong) e VC-16 (Zhongting) do canal curioso Ren Mai. Rev Paul Acupunt. 1996; 2(1): 29–33.
- Yekeler E, Tunaci M, Tunaci A, et al. Frequency of sternal variations and anomalies evaluated by MDCT. AJR Am J Roentgenol. 2006; 186(4): 956–960.
