Contribution of the computed tomography of the anatomical aspects of the sphenoid sinuses to forensic identification

Introduction: Body identification is the cornerstone of forensic investigation. It can be per formed using radiographic techniques, if antemortem images are available. This study was designed to assess the value of visual comparison of the computed tomography (CT) anatomical aspects of the sphenoid sinuses, in forensic individual identification, especially if antemortem dental records, fingerprints or DNA samples are not available. Material and methods: This retrospective work took place in a French university hospital. The supervisor of this study randomly selected from the picture archiving and communication system (PACS), 58 patients who underwent one (16 patients) or two (42 patients) head CT in various neurological contexts. To avoid bias, those studies were prepared (anonymized, and all the head structures but the sphenoid sinuses were excluded), and used to constitute two working lists of 50 (42 + 8) CT studies of the sphenoid sinuses. An anatomical classification system of the sphenoid sinuses anatomical variations was created based on the anatomical and surgical literature. In these two working lists, three blinded readers had to identify, using the anatomical system and subjective visual comparison, 42 pairs of matched studies, and 16 unmatched studies. Readers were blinded from the exact numbers of matching studies. Results: Each reader correctly identified the 42 pairs of CT with a concordance of 100% [97.5% confidence interval: 91-100%], and the 16 unmatched CT with a concordance of 100% [97.5% confidence interval: 79-100%]. Overall accuracy was 100%. Conclusion: Our study shows that establishing the anatomical concordance of the sphenoid sinuses by visual comparison could be used in personal identification. This easy method, based on a frequently and increasingly prescribed exam, still needs to be assessed on a postmortem cohort. (C) 2016 Elsevier Masson SAS. All rights reserved.