Cranial Suture Measurement by 2-point Method in Ultrasound Screening of Craniosynostosis

Abstract

Background: Diagnostic imaging for craniosynostosis currently relies entirely on radiation images, but it has been estimated that a risk of cancer from diagnostic x-rays may exist. Use of ultrasound imaging has been reported, but very little has been written on normal findings of the cranial suture. Also, ultrasound diagnostic methods have not been established. To obtain images for the diagnosis of abnormal sutures in craniosynostosis, we investigated the normal ultrasonographic appearance of the suture. To establish screening methods for craniosynostosis, we prepared a 2-point method for simple evaluation and confirmed its usefulness. Methods: Ultrasonography was performed in infants with normal head, deformational plagiocephaly, and craniosynostosis. We focused on the measurement indices and decided on the order for making our observations. Furthermore, we developed an evaluation method (2-point method) and recorded our finding in a useful table. Results: We could clearly judge whether the cranial suture was patent or closed and were able to measure the suture width. Even for 2-year-old children, the width of the sutures at the points measured exceeded the echocardiographic resolution. By using the 2-point evaluation method, all the sutures could be inspected in about 2 minutes. Sensitivity was 100% and specificity was 95.1%. Conclusions: Our present studies showed that normal or abnormal suture can be clearly distinguished by ultrasound. By evaluating the fixed points instead of the whole line, it was possible to shorten the inspection time. Ultrasound screening by applying the 2-point method is very useful.

Surface Cranial Ultrasound: The Natural Heir to X-Ray for the Screening of Skull Deformities in Infants

“…SCUS is particularly relevant in PP, as also suggested by other groups [25,23,24,26]. In our series, none of the PP children were confirmed as CS.…”

“…In children about one year old, the technique becomes less significant because it recognizes the "gap" between two bones that progressively decreases, as documented by CT on normal children [22]. Contrary to Okamoto [23], who reported some diagnoses after one year using ultrasound, we found the method problematic in older children due to lower compliance and the presence of thick hair. We consider the "golden age" for SCUS to be between 3 and 6 months.…”

Point-of-care Ultrasound to Distinguish Subgaleal and Cephalohematoma: Case Report

“…The discontinuity is seen as a thin anechoic gap in the cranium. 4 If the fluid collection crosses over the suture line, findings are consistent with a subgaleal hematoma. If the fluid collection does not cross the suture line, results are more consistent with a cephalohematoma.…”

Skull and scalp ultrasound in children: a review

“…Выполнена УС головного мозга и костей черепа, выявлены признаки перелома Основными УС-признаками синостоза шва являются отсутствие «гипоэхогенной щели» между костями свода черепа и симптом костного «гребня» в области патологического шва (рис. 6) [8,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41].…”