Evaluating sternum development and ossification through computed tomography images: a comparative analysis across age and sex

Abstract

Background: The development of the sternum begins during the intrauterine life and continues until the age of 25. However, specific information on the ages at which sternum development is complete remains limited. The aim of this study was to identify the cut-off ages for ossification and fusion of the sternal parts and segments, specifically the manubrium, sternal body, and its segments, in both sexes. Materials and methods: Computed tomography images of the thorax for 480 individuals (215 females and 265 males) aged from 0 to 25 years were analysed to determine the number of ossification centres in the sternal parts. A receiver operating characteristic (ROC) analysis was used to evaluate the ossification and fusion of the sternum segments for the ages at which ossification and fusion occurred for both sexes. Results: The ROC analysis results indicated that the sternal body showed the most significant age-related ossification in both sexes. The optimal cut-off ages for ossification of the manubrium and sternal body were 4 and 15 years for females and 5 and 15 years for males, respectively (p = 0.001). Age significantly influenced the fusion of the sternum segments. The S1–S2 fusion had the highest area under the curve. Conclusions: The results of this study emphasise the importance of age in sternum ossification and fusion. Age-specific ossification patterns were most pronounced in the sternal body. The ROC analysis provided the critical age cut-off points for the developmental stages of the sternum in both sexes.