Abstract
Background
Minimizing the ionizing radiation dose to children is fundamental to pediatric radiology. The most widely accepted imaging examination for evaluating craniosynostosis is computed tomography (CT) of the head, an examination that involves ionizing radiation.
Objective
To determine if sonography of the cranial sutures is an adequate screening examination for the diagnosis of craniosynostosis in patients with abnormal skull shape.
Materials and methods
A retrospective review of all cranial suture ultrasound (US) examinations performed during the course of a 3-year period (July 2012 – September 2015) was undertaken. Results were compared with clinical follow-up and/or head CT to evaluate the accuracy of this modality as a screening tool to determine the presence or absence of craniosynostosis. Fifty-two sonographic exams were adequate for inclusion.
Results
Forty-five of the examinations did not reveal synostosis. In each of these instances, follow-up physical exam findings and/or CT imaging confirmed that no abnormal premature suture closure was present. US findings demonstrated synostosis in seven cases. CT exam or operative reports of these cases confirmed all seven findings of premature suture closure. Statistical analysis demonstrated a sensitivity of 100% (95% confidence interval [CI]: 56.1–100.0%), a specificity of 100% (95% CI: 90.2–100.0%), and a negative predictive value of 100% (95% CI: 90.2–100.0%).
Conclusion
Cranial US is a reliable screening tool to rule out craniosynostosis in patients with abnormal head shape.
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Acknowledgements
The authors would like to thank Kathryn Leigh Foster for her assistance with the medical illustrations and Andrea F. McClynn for her assistance in the statistical analysis.
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The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the United States Government.
Research data derived from a Naval Medical Center, Portsmouth IRB/IACUC approved protocol, NMCP.2016.0013.
Drs. Hall, Besachio, Moore and Mora are military service members. This work was prepared as part of their official duties. Title 17 U.S.C. 105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person’s official duties.
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Hall, K.M., Besachio, D.A., Moore, M.D. et al. Effectiveness of screening for craniosynostosis with ultrasound: a retrospective review. Pediatr Radiol 47, 606–612 (2017). https://doi.org/10.1007/s00247-017-3793-1
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DOI: https://doi.org/10.1007/s00247-017-3793-1