Three-dimensional skull models as a problem-solving tool in suspected child abuse
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The value of 3-D skull models in evaluation of young children with suspected child abuse is not known.
The purpose of this study was to assess the value of 3-D skull models as a problem-solving tool in children younger than 2 years.
Materials and methods
We performed a retrospective study on 73 children (ages 0–24 months) seen by a child protection team (CPT) who were undergoing head CT between August 2007 and July 2009.
Of the 73 children, volume-rendered 3-D models were obtained in 26 (35.6%). Three-dimensional models changed initial CT interpretation in nine instances (34.6%). Findings thought to be fractures were confirmed as normal variants in four children. Depressed fractures were correctly shown to be ping-pong fractures in two cases. In one case, an uncertain finding was confirmed as a fracture, and an additional contralateral fracture was identified in one child. A fracture seen on skull radiographs but not seen on axial CT images was identified on the 3-D model in one case. Changes in interpretation led to modification in management in five children.
Use of 3-D skull models can be a problem-solving tool when there is discordance among the CT reading, subsequent radiographic investigations and clinical evaluation.
- Tung GA, Kumar M, Richardson RC et al (2006) Comparison of accidental and nonaccidental traumatic head injury in children on noncontrast computed tomography. Pediatrics 118:626–633 CrossRef
- Foerster BR, Petrou M, Lin D et al (2009) Neuroimaging evaluation of non-accidental head trauma with correlation to clinical outcomes: a review of 57 cases. J Pediatr 154:573–577 CrossRef
- Kemp AM, Butler A, Morris S et al (2006) Which radiological investigations should be performed to identify fractures in suspected child abuse? Clin Radiol 61:723–736 CrossRef
- Medina LS (2000) Three-dimensional CT maximum intensity projections of the calvaria: a new approach for diagnosis of craniosynostosis and fractures. Am J Neuroradiol 21:1951–1954
- Mulroy MH, Loyd AM, Frush DP et al (2012) Evaluation of pediatric skull fracture imaging techniques. Forensic Sci Int 214:167–172
- Choudhary AK, Jha B, Boal DK et al (2010) Occipital sutures and its variations: the value of 3D-CT and how to differentiate it from fractures using 3D-CT? Surg Radiol Anat 32:807–816 CrossRef
- Section of Radiology, American Academy of Pediatrics (2009) Diagnostic imaging of child abuse. Pediatrics 123:1430–1435 CrossRef
- Perez-Rossello JM, Connolly SA, Newton AW et al (2010) Whole-body MRI in suspected infant abuse. Am J Roentgenol 195:744–750 CrossRef
- Wei SC, Ulmer S, Lev MH et al (2010) Value of coronal reformations in the CT evaluation of acute head trauma. Am J Neuroradiol 31:334–339 CrossRef
- Zacharia TT, Nguyen DT (2010) Subtle pathology detection with multidetector row coronal and sagittal CT reformations in acute head trauma. Emerg Radiol 17:97–102 CrossRef
- Arnholz D, Hymel KP, Hay TC et al (1998) Bilateral pediatric skull fractures: accident or abuse? J Trauma 45:172–174 CrossRef
- Kleinman PK, Barnes PD (1998) Diagnostic imaging of child abuse, 2nd edn. Mosby, St. Louis
- Zia Z, Morris AM, Paw R (2007) Ping-pong fracture. Emerg Med J 24:731 CrossRef
- Prabhu SP, Young-Poussaint T (2010) Pediatric central nervous system emergencies. Neuroimaging Clin N Am 20:663–683 CrossRef
- White KS (1996) Invited article: helical/spiral CT scanning: a pediatric radiology perspective. Pediatr Radiol 26:5–14 CrossRef
- Hu H (1999) Multi-slice helical CT: scan and reconstruction. Med Phys 26:5–18 CrossRef
- Tzedakis A, Perisinakis K, Raissaki M et al (2006) The effect of z overscanning on radiation burden of pediatric patients undergoing head CT with multidetector scanners: a Monte Carlo study. Med Phys 33:2472–2478 CrossRef
- Halpin SF (2004) Brain imaging using multislice CT: a personal perspective. Br J Radiol 77:S20–S26 CrossRef
- Abdeen N, Chakraborty S, Nguyen T et al (2010) Comparison of image quality and lens dose in helical and sequentially acquired head CT. Clin Radiol 65:868–873 CrossRef
- Schilham A, van der Molen AJ, Prokop M et al (2010) Overranging at multisection CT: an underestimated source of excess radiation exposure. Radiographics 30:1057–1067 CrossRef
- Bushberg JT (2012) The essential physics of medical imaging, 3rd edn. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia
- Strauss KJ, Goske MJ, Kaste SC et al (2010) Image gently: ten steps you can take to optimize image quality and lower CT dose for pediatric patients. Am J Roentgenol 194:868–873 CrossRef
- Philipp MO, Kubin K, Mang T et al (2003) Three-dimensional volume rendering of multidetector-row CT data: applicable for emergency radiology. Eur J Radiol 48:33–38 CrossRef
- Fishman EK, Ney DR (1993) Advanced computer applications in radiology: clinical applications. Radiographics 13:463–475
- Kuszyk BS, Heath DG, Bliss DF et al (1996) Skeletal 3-D CT: advantages of volume rendering over surface rendering. Skeletal Radiol 25:207–214 CrossRef
- Three-dimensional skull models as a problem-solving tool in suspected child abuse
Volume 43, Issue 5 , pp 575-581
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Volume rendering
- Non-accidental trauma
- Child protection
- Industry Sectors
- Author Affiliations
- 1. Department of Radiology, Harvard Medical School, Boston Children’s Hospital, 300 Longwood Ave., Boston, MA, 02115, USA
- 2. Department of Pediatrics, Harvard Medical School, Child Protection Program, Boston Children’s Hospital, Boston, MA, USA