Sternum Gelişiminin Çok Kesitli Bilgisayarlı Tomografi ile Değerlendirilmesi

Abstract

Sternum is known to develop from six seperate ossification centers. Ossification starts in the cranial parts and continues caudally, whereas union between each center begins caudally and progresses cranially. With the development of MDCT, sternum can be studied extensively. In this study we aim to evaluate the presence and development of each ossification center, the union between them and to describe the relation with age. Patients who underwent an MDCT study were retrospectiely searched and 561 patients aged 0-30 years, were reached. 269 of them were classified as normal, patients with chronic and syndromic diseases are compared with the normal group. First three ossification centers are present in all of the individuals in the normal group. First ossification center is always seen as a single center in people older than 9 years old, while second-fourth ossification centers are always seen as single centers after the age of 13. Fifth ossification center isn't seen in 39% of people aged 0-15 years. Sixth ossification center (xiphoid process) is present more frequently in older age groups. The union of first and second ossification centers shows heterogenity among different age groups though it is seen rarely in younger individiuals. The youngest individiul with union in this level is 3 years old. The union of second and third ossification centers is always present after the age of 23. If the cut-off age is chosen as 11 year-old, the sensitivitiy is 76.8%, specificity is 94.9% and accuracy is 84.7%. Similarly, the union of third and fourth ossification centers is always present after the age of 17. If the cutt-off age is chosen as 9 year-old, the sensitivitiy is 75.3%, specificity is 93.1% and accuracy is 80.6%. fifth ossification is not always present in every normal individual, though if it is present, union with the fourth ossification center is always seen if the individual is older than 12 years old. In conclusion, we can use whether sternal ossification centers are single or multipartiated or the union between them during age estimation.