Pediatric Radiology

, Volume 43, Issue 5, pp 575–581

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

  • Sanjay P. Prabhu
  • Alice W. Newton
  • Jeannette M. Perez-Rossello
  • Paul K. Kleinman
Original Article

DOI: 10.1007/s00247-012-2546-4

Cite this article as:
Prabhu, S.P., Newton, A.W., Perez-Rossello, J.M. et al. Pediatr Radiol (2013) 43: 575. doi:10.1007/s00247-012-2546-4



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.


CT 3-D Volume rendering Non-accidental trauma Child protection 

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Sanjay P. Prabhu
    • 1
  • Alice W. Newton
    • 2
  • Jeannette M. Perez-Rossello
    • 1
  • Paul K. Kleinman
    • 1
  1. 1.Department of Radiology, Harvard Medical SchoolBoston Children’s HospitalBostonUSA
  2. 2.Department of Pediatrics, Harvard Medical School, Child Protection ProgramBoston Children’s HospitalBostonUSA

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