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Three-dimensional skull models as a problem-solving tool in suspected child abuse

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Abstract

Background

The value of 3-D skull models in evaluation of young children with suspected child abuse is not known.

Objective

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Radiology, Harvard Medical School, Boston Children’s Hospital, 300 Longwood Ave., Boston, MA, 02115, USA

    Sanjay P. Prabhu, Jeannette M. Perez-Rossello & Paul K. Kleinman

  2. Department of Pediatrics, Harvard Medical School, Child Protection Program, Boston Children’s Hospital, Boston, MA, USA

    Alice W. Newton

Authors
  1. Sanjay P. Prabhu
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  2. Alice W. Newton
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  3. Jeannette M. Perez-Rossello
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  4. Paul K. Kleinman
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Corresponding author

Correspondence to Sanjay P. Prabhu.

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Prabhu, S.P., Newton, A.W., Perez-Rossello, J.M. et al. Three-dimensional skull models as a problem-solving tool in suspected child abuse. Pediatr Radiol 43, 575–581 (2013). https://doi.org/10.1007/s00247-012-2546-4

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  • DOI: https://doi.org/10.1007/s00247-012-2546-4

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