Abstract
Purpose
The characteristic features of prematurely fused craniosynostosis in plain radiographs have already been described in literature, but there is no clinical trial investigating the individual features of every single form of craniosynostosis. We described suture-specific characteristics as well as its frequency of appearance in plain radiographs in every different form of craniosynostosis. Intraoperative findings served as control to confirm the diagnosis.
Methods
One hundred twenty-seven children with prematurely fused cranial sutures who underwent a skull X-ray from 2008 to 2012 were investigated in the present study. In detail, 34 children with frontal, 60 with sagittal, 13 with unilateral and 14 with bilateral coronal synostosis and 3 with unilateral lambdoid craniosynostosis as well as 3 children with a bilateral lambdoid synostosis were included.
Results
Typical radiological characteristics in craniosynostosis exist. These features as well as its frequency in craniosynostosis in plain skull radiographs are presented. In all cases, these typical features enabled a correct diagnosis, which was confirmed by intraoperative findings.
Conclusion
The frequency of the appearance of typical features is listed and may serve as a “mental internal check list” in the radiological approach to craniosynostosis. The study points out the value of plain skull X-rays as it enabled proper diagnosis in all investigated 127 cases.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Collmann H, Soerensen N, Krauss J (1999) Craniosynostosis. Treatment, results and complications. Churchill-Livingstone, London
David JD, Poswillo D, Simpson D (1982) The craniosynostoses causes, natural history, and management. Springer Verlag, Berlin Heidelberg New York
Thompson DN, R.D. H (1999) Craniosynostosis-pathophysiology, clinical presentation and investigation. Churchill-Livingstone, London Edinburgh New York Philadelphia Sydney Toronto
Regelsberger J, Delling G, Helmke K, Tsokos M, Kammler G, Kranzlein H, Westphal M (2006) Ultrasound in the diagnosis of craniosynostosis. J Craniofac Surg 17:623–625, discussion 626–628
Fearon JA (2014) Evidence-based medicine: craniosynostosis. Plast Reconstr Surg 133:1261–1275
Schweitzer T, Bohm H, Meyer-Marcotty P, Collmann H, Ernestus RI, Krauss J (2012) Avoiding CT scans in children with single-suture craniosynostosis. Child’s Nervous Syst: ChNS: Off J Int Soc Pediatr Neurosurg 28:1077–1082
Bundesärztekammer (2007) Leitlinie der Bundesärztekammer zur Qualitätssicherung in der Röntgendiagnostik.
Cerovac S, Neil-Dwyer JG, Rich P, Jones BM, Hayward RD (2002) Are routine preoperative CT scans necessary in the management of single suture craniosynostosis? Br J Neurosurg 16:348–354
Wilbrand JF, Szczukowski A, Blecher JC, Pons-Kuehnemann J, Christophis P, Howaldt HP, Schaaf H (2012) Objectification of cranial vault correction for craniosynostosis by three-dimensional photography. J Cranio-Maxillo-Fac Surg: Off Publ Eur Assoc Cranio-Maxillo-Fac Surg 40:726–730
Lam I, Cunningham M, Speltz M, Shapiro L (2014) Classifying craniosynostosis with a 3D projection-based feature extraction system. Proc / IEEE Int Symp Comput-Based Med Syst IEEE Int Symp Comput-Based Med Syst 2014:215–220
Aviv RI, Rodger E, Hall CM (2002) Craniosynostosis. Clin Radiol 57:93–102
Zitelli BJDH (2002) Atlas of pediatric physical diagnosis, 4th edn. Mosby, St Louis, pp 803–817
Kabbani H, Raghuveer TS (2004) Craniosynostosis. Am Fam Phys 69:2863–2870
Brenner D, Elliston C, Hall E, Berdon W (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 176:289–296
Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357:2277–2284
Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, Howe NL, Ronckers CM, Rajaraman P, Sir Craft AW, Parker L, Berrington de Gonzalez A (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380:499–505
Miglioretti DL, Johnson E, Williams A, Greenlee RT, Weinmann S, Solberg LI, Feigelson HS, Roblin D, Flynn MJ, Vanneman N, Smith-Bindman R (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167:700–707
Bernier MO, Rehel JL, Brisse HJ, Wu-Zhou X, Caer-Lorho S, Jacob S, Chateil JF, Aubert B, Laurier D (2012) Radiation exposure from CT in early childhood: a French large-scale multicentre study. Br J Radiol 85:53–60
Silverman F, Kuhn J (1993) Caffey’s pediatric x-ray diagnosis: an integrated imaging approach
Cohen MM Jr, MacLean ER (2000) Craniosynostosis diagnosis, evaluation, and management. Oxford University Press, New York
van der Meulen J (2012) Metopic synostosis. Child’s Nerv Syst: ChNS: Off J Int Soc Pediatr Neurosurg 28:1359–1367
Muenke M, Kress W, Collmann H, Solomon BD (2011) Craniosynostosis in monographs in human genetics. Karger Basel Chapter 18: 217
Linz C, Collmann H, Meyer-Marcotty P, Bohm H, Krauss J, Muller-Richter UD, Ernestus RI, Wirbelauer J, Kubler AC, Schweitzer T (2015) Occipital plagiocephaly: unilateral lambdoid synostosis versus positional plagiocephaly. Arch Dis Childhood 100:152–157
Funding source
No funding was secured for this study.
Financial disclosure
The authors have no financial relationships relevant to this article to disclose.
Conflict of interest
The authors declare that they have no competing of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schweitzer, T., Kunz, F., Meyer-Marcotty, P. et al. Diagnostic features of prematurely fused cranial sutures on plain skull X-rays. Childs Nerv Syst 31, 2071–2080 (2015). https://doi.org/10.1007/s00381-015-2890-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-015-2890-4