Ian Whittall1, William A Lambert1, Douglas J Moote2, Markus J Bookland3,4,5, Jonathan E Martin3,4, Christopher D Hughes4,6, David S Hersh7,8,9. 1. UConn School of Medicine, Farmington, CT, USA. 2. Division of Radiology, Connecticut Children's, Hartford, CT, USA. 3. Division of Neurosurgery, Connecticut Children's, Hartford, CT, USA. 4. Department of Surgery, UConn School of Medicine, Farmington, CT, USA. 5. Department of Pediatrics, UConn School of Medicine, Farmington, CT, USA. 6. Division of Plastic Surgery, Connecticut Children's, Hartford, CT, USA. 7. Division of Neurosurgery, Connecticut Children's, Hartford, CT, USA. dhersh@connecticutchildrens.org. 8. Department of Surgery, UConn School of Medicine, Farmington, CT, USA. dhersh@connecticutchildrens.org. 9. Department of Pediatrics, UConn School of Medicine, Farmington, CT, USA. dhersh@connecticutchildrens.org.
Abstract
INTRODUCTION: The optimal protocol for diagnostic workup of craniosynostosis and the role of specific imaging modalities remain controversial. Skull X-rays and 3-dimensional head CTs are options when physical exam is equivocal but involve ionizing radiation. Ultrasound has emerged as an alternative modality for visualization of cranial sutures, but its use is not widespread. METHODS: The authors performed a systematic review of the literature on the use of ultrasound for the diagnosis of craniosynostosis. RESULTS: A total of 12 studies involving 1062 patients were included. Overall, 300 patients (28.2%) were diagnosed with craniosynostosis. A total of 369 (34.7%) patients had their diagnosis (craniosynostosis vs. patent sutures) confirmed with another imaging modality in addition to ultrasound. Among studies, the specificity of ultrasound ranged from 86 to 100%, and the sensitivity from 71 to 100%. CONCLUSIONS: Ultrasonography of cranial sutures is a feasible and accurate tool for the diagnosis of single-suture craniosynostosis when physical exam findings are insufficient. Although technical aspects of ultrasonography and its interpretation have an associated learning curve, ultrasound can achieve high sensitivity and specificity among patients with suspected craniosynostosis.
INTRODUCTION: The optimal protocol for diagnostic workup of craniosynostosis and the role of specific imaging modalities remain controversial. Skull X-rays and 3-dimensional head CTs are options when physical exam is equivocal but involve ionizing radiation. Ultrasound has emerged as an alternative modality for visualization of cranial sutures, but its use is not widespread. METHODS: The authors performed a systematic review of the literature on the use of ultrasound for the diagnosis of craniosynostosis. RESULTS: A total of 12 studies involving 1062 patients were included. Overall, 300 patients (28.2%) were diagnosed with craniosynostosis. A total of 369 (34.7%) patients had their diagnosis (craniosynostosis vs. patent sutures) confirmed with another imaging modality in addition to ultrasound. Among studies, the specificity of ultrasound ranged from 86 to 100%, and the sensitivity from 71 to 100%. CONCLUSIONS: Ultrasonography of cranial sutures is a feasible and accurate tool for the diagnosis of single-suture craniosynostosis when physical exam findings are insufficient. Although technical aspects of ultrasonography and its interpretation have an associated learning curve, ultrasound can achieve high sensitivity and specificity among patients with suspected craniosynostosis.
Authors: M W Vannier; T K Pilgram; J L Marsh; B B Kraemer; S C Rayne; M H Gado; C J Moran; W H McAlister; G D Shackelford; R A Hardesty Journal: AJNR Am J Neuroradiol Date: 1994-11 Impact factor: 3.825