Skip to main content
Erschienen in: European Journal of Plastic Surgery 2/2014

01.02.2014 | Original Paper

Cranial sutures ultrasonography as a valid diagnostic tool in isolated craniosynostoses: a pilot study

verfasst von: Gianmarco Saponaro, Silvia Bernardo, Paolo Di Curzio, Emanuela Basile, Emanuela Rastelli, Stefano Martini, Valeria Vinci, Matteo Saldari, Lucia Manganaro, Piero Cascone

Erschienen in: European Journal of Plastic Surgery | Ausgabe 2/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Craniosynostoses are the most frequent craniofacial malformations. Diagnosis has for long time relied on standard radiographs, and still nowadays, they are of first step in the evaluation of suspected craniosynostosis. CT and MRI scans are also valuable tools for further diagnostics in craniosynostoses, but they expose the children to a large amount of radiation or they require sedation due to scarce patient compliance. The value of ultrasound as a screening tool for craniosynostosis remains non-established, but it offers a non-expensive, non-risky, and fast mean of detection for sutural growth impairment. The aim of this study is to demonstrate the effectiveness of the use of ultrasound as a diagnostic and follow-up tool in newborn children affected by craniostenoses.

Methods

We have selected 17 children, whose clinical findings were clinically suggestive for craniostenosis or head molding. All patients underwent an ultrasound examination, and those positive for craniostenosis or with an uncertain diagnosis also underwent CT scan examination. All patients positive for craniosynostosis and patients in which diagnosis was still unsure also underwent a CT scan examination for further confirmations; results from CT scan were then compared to those obtained with ultrasound examinations.

Results

Five infants had normal appearance of the cranial sutures on US. In 12/17 infants, US identified premature closure of one or more cranial sutures in particular. Results from CT scan compared to those obtained with US examinations showed a 100 % match between the two techniques.

Conclusions

In our experience, ultrasound examination has shown to be an effective, fast, inexpensive, and non-risky method for diagnosis and assessments in children with craniostenoses and was able to detect the presence of synostosis in all patients affected with a 100 % match with CT scan examination.
Level of Evidence: Level III, diagnostic study.
Literatur
1.
Zurück zum Zitat Simanovsky N, Hiller N, Koplewitz B, Rozovsky K (2009) Effectiveness of ultrasonographic evaluation of the cranial sutures in children with suspected craniosynostosis. Eur Radiol 19(3):687–692, Epub 2008 Oct 22PubMedCrossRef Simanovsky N, Hiller N, Koplewitz B, Rozovsky K (2009) Effectiveness of ultrasonographic evaluation of the cranial sutures in children with suspected craniosynostosis. Eur Radiol 19(3):687–692, Epub 2008 Oct 22PubMedCrossRef
2.
Zurück zum Zitat Richtsmeier JT, Grausz HM, Morris GR, Marsh JL, Vannier MW (1991) Growth of the cranial base in craniosynostosis. Cleft Palate Craniofac J 28(1):55–67, 109PubMedCrossRef Richtsmeier JT, Grausz HM, Morris GR, Marsh JL, Vannier MW (1991) Growth of the cranial base in craniosynostosis. Cleft Palate Craniofac J 28(1):55–67, 109PubMedCrossRef
3.
Zurück zum Zitat Frassanito P, Di Rocco C (2011) Depicting cranial sutures: a travel into the history. Childs Nerv Syst 27(8):1181–1183PubMedCrossRef Frassanito P, Di Rocco C (2011) Depicting cranial sutures: a travel into the history. Childs Nerv Syst 27(8):1181–1183PubMedCrossRef
4.
Zurück zum Zitat Cerovac S, Neil-Dwyer JG, Rich P, Jones BM, Hayward RD (2002) Are routine preoperative CT scans necessary in the management of single suture craniosynostosis? Br J Neurosurg 16(4):348–354PubMedCrossRef Cerovac S, Neil-Dwyer JG, Rich P, Jones BM, Hayward RD (2002) Are routine preoperative CT scans necessary in the management of single suture craniosynostosis? Br J Neurosurg 16(4):348–354PubMedCrossRef
5.
Zurück zum Zitat Agrawal D, Steinbok P, Cochrane DD (2006) Diagnosis of isolated sagittal synostosis: are radiographic studies necessary? Childs Nerv Syst 22(4):375–378, Epub 2005 Sep 27PubMedCrossRef Agrawal D, Steinbok P, Cochrane DD (2006) Diagnosis of isolated sagittal synostosis: are radiographic studies necessary? Childs Nerv Syst 22(4):375–378, Epub 2005 Sep 27PubMedCrossRef
6.
Zurück zum Zitat Massimi L, Caldarelli M, Tamburrini G, Paternoster G, Di Rocco C (2012) Isolated sagittal craniosynostosis: definition, classification, and surgical indications. Childs Nerv Syst 28(9):1311–1317, Epub 2012 Aug 8PubMedCrossRef Massimi L, Caldarelli M, Tamburrini G, Paternoster G, Di Rocco C (2012) Isolated sagittal craniosynostosis: definition, classification, and surgical indications. Childs Nerv Syst 28(9):1311–1317, Epub 2012 Aug 8PubMedCrossRef
7.
Zurück zum Zitat Kotrikova B, Krempien R, Freier K, Mühling J (2007) Diagnostic imaging in the management of craniosynostoses. Eur Radiol 17(8):1968–1978, Epub 2006 Dec 7PubMedCrossRef Kotrikova B, Krempien R, Freier K, Mühling J (2007) Diagnostic imaging in the management of craniosynostoses. Eur Radiol 17(8):1968–1978, Epub 2006 Dec 7PubMedCrossRef
8.
Zurück zum Zitat Kirmi O, Lo SJ, Johnson D, Anslow P (2009) Craniosynostosis: a radiological and surgical perspective. Semin Ultrasound CT MR 30(6):492–512, ReviewPubMedCrossRef Kirmi O, Lo SJ, Johnson D, Anslow P (2009) Craniosynostosis: a radiological and surgical perspective. Semin Ultrasound CT MR 30(6):492–512, ReviewPubMedCrossRef
9.
Zurück zum Zitat Medina LS, Richardson RR, Crone K (2002) Children with suspected craniosynostosis: a cost-effectiveness analysis of diagnostic strategies. AJR Am J Roentgenol 179(1):215–221PubMedCrossRef Medina LS, Richardson RR, Crone K (2002) Children with suspected craniosynostosis: a cost-effectiveness analysis of diagnostic strategies. AJR Am J Roentgenol 179(1):215–221PubMedCrossRef
10.
Zurück zum Zitat Mitchell LA, Kitley CA, Armitage TL, Krasnokutsky MV, Rooks VJ (2011) Normal sagittal and coronal suture widths by using CT imaging. AJNR Am J Neuroradiol 32(10):1801–1805, Epub 2011 Sep 15PubMedCrossRef Mitchell LA, Kitley CA, Armitage TL, Krasnokutsky MV, Rooks VJ (2011) Normal sagittal and coronal suture widths by using CT imaging. AJNR Am J Neuroradiol 32(10):1801–1805, Epub 2011 Sep 15PubMedCrossRef
11.
Zurück zum Zitat Branson HM, Shroff MM (2011) Craniosynostosis and 3-dimensional computed tomography. Semin Ultrasound CT MR 32(6):569–577PubMedCrossRef Branson HM, Shroff MM (2011) Craniosynostosis and 3-dimensional computed tomography. Semin Ultrasound CT MR 32(6):569–577PubMedCrossRef
12.
Zurück zum Zitat Pelo S, Tamburrini G, Marianetti TM, Saponaro G, Moro A, Gasparini G, Di Rocco C (2011) Correlations between the abnormal development of the skull base and facial skeleton growth in anterior synostotic plagiocephaly: the predictive value of a classification based on CT scan examination. Childs Nerv Syst 27(9):1431–1443, Epub 2011 Jul 1PubMedCrossRef Pelo S, Tamburrini G, Marianetti TM, Saponaro G, Moro A, Gasparini G, Di Rocco C (2011) Correlations between the abnormal development of the skull base and facial skeleton growth in anterior synostotic plagiocephaly: the predictive value of a classification based on CT scan examination. Childs Nerv Syst 27(9):1431–1443, Epub 2011 Jul 1PubMedCrossRef
13.
Zurück zum Zitat Sze RW, Parisi MT, Sidhu M, Paladin AM, Ngo AV, Seidel KD, Weinberger E, Ellenbogen RG, Gruss JS, Cunningham ML (2003) Ultrasound screening of the lambdoid suture in the child with posterior plagiocephaly. Pediatr Radiol 33(9):630–636, Epub 2003 Jul 18PubMedCrossRef Sze RW, Parisi MT, Sidhu M, Paladin AM, Ngo AV, Seidel KD, Weinberger E, Ellenbogen RG, Gruss JS, Cunningham ML (2003) Ultrasound screening of the lambdoid suture in the child with posterior plagiocephaly. Pediatr Radiol 33(9):630–636, Epub 2003 Jul 18PubMedCrossRef
14.
Zurück zum Zitat Regelsberger J, Delling G, Helmke K, Tsokos M, Kammler G, Kränzlein H, Westphal M (2006) Ultrasound in the diagnosis of craniosynostosis. J Craniofac Surg 17(4):623–5, discussion 626–8PubMedCrossRef Regelsberger J, Delling G, Helmke K, Tsokos M, Kammler G, Kränzlein H, Westphal M (2006) Ultrasound in the diagnosis of craniosynostosis. J Craniofac Surg 17(4):623–5, discussion 626–8PubMedCrossRef
15.
Zurück zum Zitat Soboleski D, Mussari B, McCloskey D, Sauerbrei E, Espinosa F, Fletcher A (1998) High-resolution sonography of the abnormal cranial suture. Pediatr Radiol 28(2):79–82PubMedCrossRef Soboleski D, Mussari B, McCloskey D, Sauerbrei E, Espinosa F, Fletcher A (1998) High-resolution sonography of the abnormal cranial suture. Pediatr Radiol 28(2):79–82PubMedCrossRef
Metadaten
Titel
Cranial sutures ultrasonography as a valid diagnostic tool in isolated craniosynostoses: a pilot study
verfasst von
Gianmarco Saponaro
Silvia Bernardo
Paolo Di Curzio
Emanuela Basile
Emanuela Rastelli
Stefano Martini
Valeria Vinci
Matteo Saldari
Lucia Manganaro
Piero Cascone
Publikationsdatum
01.02.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Plastic Surgery / Ausgabe 2/2014
Print ISSN: 0930-343X
Elektronische ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-013-0898-0

Weitere Artikel der Ausgabe 2/2014

European Journal of Plastic Surgery 2/2014 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.