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MDCT diagnosis of the child with posterior plagiocephaly
Raymond W Sze1, Richard A Hopper, Victor Ghioni
1Department of Radiology, University of Washington, 4800 Sand Point Way NE, PO Box 5371/CH-69, Seattle, WA 98105-0371, USA. raymond.sze@seattle.childrens.org
Insights
This review covers posterior skull base anatomy and imaging for posterior plagiocephaly, differentiating common causes like deformational plagiocephaly and lambdoid synostosis.
Area of Science:
- Pediatric Radiology
- Craniofacial Anatomy
- Medical Imaging
Background:
- Posterior plagiocephaly presents diagnostic challenges.
- Differentiating deformational plagiocephaly from lambdoid synostosis is crucial for management.
- Unusual etiologies require advanced imaging for diagnosis.
Purpose of the Study:
- To review normal posterior skull base anatomy and development.
- To describe imaging features of common posterior plagiocephaly causes.
- To present rare cases diagnosed with multi-detector computed tomography (MDCT).
Main Methods:
- Review of normal anatomy and development of the posterior skull base.
- Analysis of imaging features for posterior deformational plagiocephaly and unilateral lambdoid synostosis.
- Case review of unusual posterior plagiocephaly using volume-reformatted MDCT.
Main Results:
- Established imaging characteristics for differentiating posterior deformational plagiocephaly and unilateral lambdoid synostosis.
- Demonstrated utility of MDCT in diagnosing rare causes, including asymmetric intraoccipital synchondroses fusion.
- Successful diagnosis of three unusual cases facilitated by advanced imaging.
Conclusions:
- Volume-reformatted multi-detector computed tomography (MDCT) is effective for diagnosing common and rare causes of pediatric posterior plagiocephaly.
- MDCT provides accurate visualization of complex anatomical variations and pathologies in the posterior skull base.
- This imaging modality aids in precise diagnosis, guiding appropriate clinical management.
Objective:
In this article, we review the normal anatomy and development of the posterior skull base and describe distinguishing imaging features of the two most common causes of posterior plagiocephaly: posterior deformational plagiocephaly and unilateral lambdoid synostosis. We also describe three unusual cases of posterior plagiocephaly, including asymmetric premature fusion of the anterior and posterior intraoccipital synchondroses, with diagnoses enabled by volume-reformatted MDCT.
Conclusion:
Three-dimensional reformatted MDCT enables accurate diagnosis of common and rare causes of posterior plagiocephaly in children.
