Craniosynostosis: diagnostic value of three-dimensional CT reconstruction.

Authors:
  • CHC F Hildebolt
    C F Hildebolt
  • JMJ L Marsh
    J L Marsh
  • TPT K Pilgram
    T K Pilgram
  • WMW H McAlister
    W H McAlister
  • GSG D Shackelford
    G D Shackelford
  • COC J Offutt
    C J Offutt
  • RKR H Knapp
    R H Knapp
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Abstract
Three-dimensional computed tomography (CT) has an important role in determining the presence and extent of congenital and acquired craniofacial deformities. The authors compared the sensitivity and specificity of three-dimensional CT in the detection and characterization of craniosynostosis with that of planar CT and skull radiography. Eighty-two patients with isolated and syndromal synostoses were imaged with CT and three-dimensional CT, and 42 with skull radiography. Three-dimensional CT scan processing was performed by shaded-surface reconstruction, volumetric, and depth-coded methods. Two trained observers read each scan series in a blinded fashion. Diagnostic utility of the images was determined with receiver operating characteristic analysis. The observers ranked three-dimensional shaded images higher than the other types, with three-dimensional volumetric images second and three-dimensional surface images ranked third. Results of this study demonstrate that three-dimensional shaded-surface reconstruction from CT scans is superior to conventional plain radiographs and CT scans in diagnosing craniosynostosis.

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