Preoperative imaging patterns and intracranial findings in single-suture craniosynostosis: a study from the Synostosis Research Group.

Autor:	Ravindra VM; 1Department of Neurosurgery, and.; 2Division of Neurosurgery, University of California, San Diego.; 3Department of Neurosurgery, Naval Medical Center San Diego, California., Awad AW; 1Department of Neurosurgery, and., Baker CM; 1Department of Neurosurgery, and., Lee A; 4Department of Neurosurgery, Seattle Children's Hospital, University of Washington, Seattle, Washington., Anderson RCE; 5Department of Neurosurgery, Columbia University, Morgan Stanley Children's Hospital, and., Gociman B; 6Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, Utah., Patel KB; 7Division of Plastic and Reconstructive Surgery, Department of Surgery, and., Smyth MD; 8Department of Neurosurgery, St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, Missouri., Birgfeld C; and Departments of9Pediatric Neurosurgery and., Pollack IF; and Departments of9Pediatric Neurosurgery and., Goldstein JA; 10Plastic Surgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania., Imahiyerobo T; 11Division of Plastic Surgery, Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, New York., Siddiqi FA; 6Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, Utah., Kestle JRW; 1Department of Neurosurgery, and.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2021 Jun 25; Vol. 28 (3), pp. 344-350. Date of Electronic Publication: 2021 Jun 25 (Print Publication: 2021).
DOI:	10.3171/2021.2.PEDS2113
Abstrakt:	Objective: The diagnosis of single-suture craniosynostosis can be made by physical examination, but the use of confirmatory imaging is common practice. The authors sought to investigate preoperative imaging use and to describe intracranial findings in children with single-suture synostosis from a large, prospective multicenter cohort. Methods: In this study from the Synostosis Research Group, the study population included children with clinically diagnosed single-suture synostosis between March 1, 2017, and October 31, 2020, at 5 institutions. The primary analysis correlated the clinical diagnosis and imaging diagnosis; secondary outcomes included intracranial findings by pathological suture type. Results: A total of 403 children (67% male) were identified with single-suture synostosis. Sagittal (n = 267), metopic (n = 77), coronal (n = 52), and lambdoid (n = 7) synostoses were reported; the most common presentation was abnormal head shape (97%), followed by a palpable or visible ridge (37%). Preoperative cranial imaging was performed in 90% of children; findings on 97% of these imaging studies matched the initial clinical diagnosis. Thirty-one additional fused sutures were identified in 18 children (5%) that differed from the clinical diagnosis. The most commonly used imaging modality by far was CT (n = 360), followed by radiography (n = 9) and MRI (n = 7). Most preoperative imaging was ordered as part of a protocolized pathway (67%); some images were obtained as a result of a nondiagnostic clinical examination (5.2%). Of the 360 patients who had CT imaging, 150 underwent total cranial vault surgery and 210 underwent strip craniectomy. The imaging findings influenced the surgical treatment 0.95% of the time. Among the 24% of children with additional (nonsynostosis) abnormal findings on CT, only 3.5% required further monitoring. Conclusions: The authors found that a clinical diagnosis of single-suture craniosynostosis and the findings on CT were the same with rare exceptions. CT imaging very rarely altered the surgical treatment of children with single-suture synostosis.
Databáze:	MEDLINE
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