Objectives: To examine the reliability and accuracy of Walker's model for estimating the sex of Han adults in western China by using cranium three-dimensional (3D) CT reconstruction, and to study the suitable cranial sex estimation model for Han people in western China.
Methods: A total of 576 cranial CT 3D reconstructed images from Hanzhong Hospital in Shaanxi Province from 2017 to 2021 were collected. These images were divided into the experimental group with 486 samples and the validation group with 90 samples. Walker's model was used by observer 1 to estimate the sex of experimental group samples. The logistic function applicable to Han people in western China was corrected by observer 1. The 90 samples in the validation group were scored and substituted into the modified logistic function to complete the back substitution test by observer 1, 2 and 3.
Results: The accuracy of sex estimation of Han adults in western China was 63.2%-77.2% by applying Walker's model. The accuracy of modified logistic function was 82.9%. The accuracy of sex estimation through back substitution test by 3 observers was 75.6%-91.1%, with a Kappa value of 0.689 (P<0.05) for inter-observer consistency and 0.874 (P<0.05) for intra-observer consistency.
Conclusions: There are great differences in bone characteristics among people from different regions. The modified logistic function can achieve higher accuracy in Han adults in western China.
目的: 利用颅骨CT三维重组技术检验Walker模型推断我国西部地区汉族成人性别的可靠性和准确性，并研究适用于西部地区汉族人群的颅骨性别推断模型。方法: 收集陕西省汉中医院2017—2021年的576例颅骨CT三维重组图像，分为实验组486例、验证组90例。观察者1采用Walker模型对实验组样本评分进行性别推断，并修正为适用于西部地区汉族样本的logistic函数，3名观察者对验证组90例样本评分，代入修正后的logistic函数完成回代检验。结果: 应用Walker模型推断西部地区汉族成人性别准确率为63.2%~77.2%，修正的性别推断模型的准确率为82.9%。3名观察者回代检验性别推断准确率为75.6%~91.1%，观察者之间Kappa一致性检验结果为0.689（P<0.05），观察者内部Kappa一致性检验结果为0.874（P<0.05）。结论: 不同地区人群骨骼特征存在差异，修正后的logistic函数在西部地区汉族成人获得了更高的准确率。.
Keywords: CT three-dimensinal restruction; Han population; cranium; forensic anthropology; sex estimation.