T2-weighted spoiled gradient echo sequence (MERGE): A different perspective on the forensic age estimation

Oguzhan Ekizoglu (Lead / Corresponding author), Ali Er, Can Doruk Basa, Ismail Eralp Kacmaz, Ismail Ozgur Can, Julieta G. García-Donas, Elena F. Kranioti

Research output: Contribution to journalConference articlepeer-review


Introduction: Age estimation methods using MRI are dependent on staging systems used in T1, T2 and fast spin-echo proton density-weighted sequences. The staging system created by Dedouit [1] from images obtained by fast spin-echo proton density-weighted MRI sequences depends on the assessment of horizontal cartilage hyperintensity. Images obtained by this method, detecting 1.5 mm hyperintensity thickness, and in some cases, detecting continuity of hyperintensity could be challenging. The purpose of this preliminary study was to investigate the utility of T2-weighted spoiled gradient echo sequence in determining the degree of ossification of epiphyses.

Material and methods: In this study, fast spin-echo proton density-weighted and MERGE T2-weighted spoiled gradient echo sequences of the knee of 25 patients (10–30 years, 10 female and 15 male) were evaluated using Dedouit et al.’s [1] five-stage method.

Results: The horizontal cartilages assessed with MERGE exhibited hyperintensity and clearly visible borders (Fig. 1). Stage 2 and 3 were easily distinguishable and the epiphyseal scar line observed in stage 5 (complete fusion) was easily observed in contrast to the fast spin-echo proton density-weighted sequence. The hyperintense line that was assessed in fast spin-echo proton density-weighted sequence in stage 3 cases was seen as continuous and intermittent hypointense line in MERGE sequence. It was suggested that substages may be necessary for the distinction of stage 3 and 4.

Discussion: At present, due to the ethical concerns, non-ionized methods (ultrasound and MRI) are more frequently used in living individuals’ age estimations. MRI assessments in spoiled T2-weighted spoiled gradient echo sequence for age determination may be advantageous in the examination of epiphyseal lines and may produce different options in staging.
Original languageEnglish
Article numberP04
Pages (from-to)189-190
Number of pages2
JournalRevue de Médecine Légale
Issue number4
Early online date8 Dec 2017
Publication statusPublished - Dec 2017


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