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Three-dimensional spiral CT of craniofacial malformations in children
S Binaghi1, F Gudinchet, B Rilliet
1Department of Radiology, University Hospital of Lausanne, CHUV, 1011 Lausanne, Switzerland. Stefano.Binaghi@chuv.hospvd.ch
Insights
Three-dimensional CT (3D CT) reliably diagnoses pediatric craniofacial bone malformations. This imaging technique aids surgeons in planning treatments for conditions like craniosynostosis and skull base abnormalities.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Craniofacial Surgery
Background:
- Paediatric craniofacial malformations require accurate diagnosis.
- Three-dimensional CT (3D CT) offers advanced visualization capabilities.
Purpose of the Study:
- To evaluate the diagnostic and management utility of 3D CT for suspected paediatric craniofacial malformations.
- To assess 3D CT's role in surgical planning for these conditions.
Main Methods:
- Craniofacial spiral CT was performed on 28 children with craniofacial or cervical malformations.
- 3D reformatting was utilized for detailed analysis using an independent workstation.
Main Results:
- 3D CT successfully evaluated 16 patients with craniosynostosis and 2 post-surgical patients.
- Malformations of the skull base, including Goldenhar-Gorlin, Treacher-Collins, and Crouzon's diseases, were clearly depicted.
- Radiological findings correlated with clinical and intraoperative data in surgically treated patients.
Conclusions:
- 3D CT is a safe and reliable method for identifying paediatric craniofacial bone malformations.
- It serves as crucial morphological mapping for surgical treatment planning.
Objective:
To assess the value of three-dimensional CT (3D CT) in the diagnosis and management of suspected paediatric craniofacial malformations.
Materials And Methods:
Twenty-eight children (12 girls, 16 boys) with a mean age of 4 years, suffering from craniofacial or cervical malformations, underwent craniofacial spiral CT. 3D reformatting was performed using an independent work-station.
Results:
3D CT allowed the preoperative evaluation of 16 patients with craniosynostosis and the post-surgical management of 2 patients. 3D CT clearly depicted malformations of the skull base involving the petrous bone in seven patients (four cases of Goldenhar-Gorlin syndrome, one case of Treacher-Collins syndrome and two cases of Crouzon's disease). Four patients with craniofacial clefts were also evaluated. Radiological findings were confirmed by the clinical and intraoperative findings in all patients that underwent surgical treatment. Movement artefacts and "Lego effect" related to abrupt change of cranial vault border were encountered and are discussed.
Conclusions:
3D CT of the skull can safely and reliably identify paediatric craniofacial malformations involving bone, and it should be used as morphological mapping to help the surgeon in planning surgical treatment.