Magnetic resonance imaging in isolated sagittal synostosis

Area of Science:

• Pediatric Neurosurgery
• Medical Imaging
• Developmental Biology

Background:

• Isolated sagittal synostosis, or scaphocephaly, is the most common craniosynostosis.
• Computed tomographic (CT) scans are standard for diagnosis and surgical planning.
• Magnetic resonance imaging (MRI) is explored as an alternative due to radiation concerns with CT and its potential for detecting intracranial anomalies.

Purpose of the Study:

• To evaluate the frequency of brain anomalies in children with isolated sagittal synostosis using preoperative MRI.
• To assess the therapeutic consequences of identified brain anomalies.
• To determine if MRI is warranted for routine preoperative evaluation in these cases.

Main Methods:

• Retrospective analysis of preoperative MRI scans from 42 children diagnosed with isolated sagittal synostosis.
• Correlation of MRI findings with clinical presentation and surgical/therapeutic outcomes.

Main Results:

• Pathologic MRI findings (e.g., ventricular dilatation, hypoplastic corpus callosum) were present in 10 patients (23.8%).
• All patients exhibited secondary brain deformation due to the skull shape.
• Clinically significant symptoms in 7 patients were not predictive of MRI findings, and vice versa.
• Detected brain anomalies did not influence surgical procedures or necessitate additional therapies.

Conclusions:

• Routine preoperative MRI is not justified for clinically normal children with isolated sagittal synostosis.
• The presence of brain anomalies on MRI did not impact management decisions in this cohort.
• CT remains the recommended imaging modality for scaphocephaly diagnosis and surgical planning.