SEX IDENTIFICATION USING STERNAL MEASUREMENTS BY MULTI-SLICE COMPUTED TOMOGRAPHY IN A SAMPLE OF THE EGYPTIAN POPULATION

Background: Sex determination from bone fragment measurements is a critical aspect of forensic medicine. Objectives: This study aimed to identify sex from sternal measurements using multi-slice computed tomography among a sample of the Egyptian population. Methods: This cross-sectional study included 180 adult Egyptians (95 males, 85 females). Three-dimensional thin multi-slice computed tomography covering the sternum was used. The sagittal images declared the manubrial length (ML), the sternal body length (BL), the combined manubrial and sternal body length (CL), and the total sternal length (TSL). The coronal images declared the manubrial width (MW), the sternal body width at the first sternebra (CS1W), and the sternal body width at the third sternebra (CS3W). The sternal index (SI) was calculated. The data were analyzed by calculating the area under the curve (AUC) and receiver operating characteristics (ROC) parameters. Results: Male sternal measurements including ML, BL, CS1W, CS3W, TSL, MW, CL, the combined ML + MW, CS3W + BL, and CS1W + CS3W were statistically higher than the female except SI was higher in females than males (p<0.001). The ML, MW, BL, SI, as well as, ML + MW and CS3W + BL, had excellent areas under the curves. At cut-off levels >8.89 of BL, < 49.83 of SI, > 5.635 of MW, and > 11.675 of CS3W + BL, the accuracy levels of male sex identification were more than 90 %. Conclusions: Using multidetector computed tomography, the MW, BL, and SI measurements were highly significant for sex determination. The CS3W + BL is a valuable option for sex identification when only the sternum can be assessed. This study will establish a database for forensic anthropology for the sex identification of skeletal remains in Egypt.