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Imaging in the Evaluation of Children with Suspected Craniosynostosis

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Book cover Evidence-Based Imaging in Pediatrics

Key Points

■ Plain skull radiography demonstrates moderate to high sensitivity and specificity in craniosynostosis.

■ Numerous publications support 3D-CT as the imaging modality with the best diagnostic performance, with reported sensitivities of 96–100%. CT also detects associated intracranial pathology.

■ Higher diagnostic performance is obtained with plain films and CT if the studies are of good quality and interpreted by an experienced reviewer.

■ Cranial sonography shows preliminary promise as a diagnostic test for craniosynostosis. The evidence is based on small cohorts; hence, larger series are needed before it is routinely used.

■ Imaging strategies for children with suspected craniosynostosis should be based on their risk group. In healthy children with head deformity including posterior plagiocephaly, skull radiography is recommended. Syndromes such as Apert, Crouzon, and Pfeiffer nearly always have associated craniosynostosis and hence require 3D imaging for surgical planning.

■ Imaging is not necessary for diagnosis or preoperative planning in isolated craniosynostosis with unequivocal clinical findings. However, in countries with high medicolegal issues, imaging may still be required.

■ Intracranial anomalies can be seen in some patients with craniosynostosis but the exact incidence is not well known.

■ Small retrospective US and MRI studies demonstrate the feasibility of prenatal diagnosis of craniosynostosis. However, large prospective studies are still required to understand the prenatal role of imaging in craniosynostosis and their effect on postnatal outcome.

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Author information

Authors and Affiliations

  1. Department of Radiology, Children’s Hospital Boston. Harvard Medical School, Boston, Massachusetts, USA

    Daniel N. Vinocur

  2. Co-Director Division of Neuroradiology and Brain Imaging, Director of the Health Outcomes, Policy, and Economics (HOPE) Center, Department of Radiology, Miami Children’s Hospital, 33155, Miami, FL, USA

    L. Santiago Medina MD, MPH

  3. Former Lecturer in Radiology, Harvard Medical School, 02114, Boston, MA, USA

    L. Santiago Medina MD, MPH

Authors
  1. Daniel N. Vinocur
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  2. L. Santiago Medina MD, MPH
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Correspondence to Daniel N. Vinocur .

Editor information

Editors and Affiliations

  1. Dept. Radiology, Miami Children's Hospital, SW 114 Street 7420, Miami , 33156, U.S.A.

    L. Santiago Medina

  2. Dept. Radiology, Riley Children's Hospital, Barnhill Drive 702 , Indianapolis, 46202-5200, U.S.A.

    Kimberly E. Applegate

  3. Harborview Medical Center, University of Washington, Ninth Avenue 325, Seattle, 98104-2499, U.S.A.

    C. Craig Blackmore

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Vinocur, D.N., Medina, L.S. (2010). Imaging in the Evaluation of Children with Suspected Craniosynostosis. In: Medina, L., Applegate, K., Blackmore, C. (eds) Evidence-Based Imaging in Pediatrics. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0922-0_4

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  • DOI: https://doi.org/10.1007/978-1-4419-0922-0_4

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  • Online ISBN: 978-1-4419-0922-0

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