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Overview of the Skull01:08

Overview of the Skull

The cranium (skull) is the skeletal structure of the head that supports the face and protects the brain. It is subdivided into the facial bones and the brain case, or cranial vault. The facial bones underlie the facial structures, form the nasal cavity, enclose the eyeballs, and support the teeth of the upper and lower jaws.
The cranial vault surrounds and protects the brain and houses the middle and inner ear structures. This cavity is bounded superiorly by the rounded top of the skull, which...
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Three-dimensional skull models as a problem-solving tool in suspected child abuse.

Sanjay P Prabhu1, Alice W Newton, Jeannette M Perez-Rossello

  • 1Department of Radiology, Harvard Medical School, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA. sanjay.prabhu@childrens.harvard.edu

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Three-dimensional (3-D) skull models aid in evaluating young children with suspected abuse. These 3-D models can resolve discrepancies in CT scans, radiographic findings, and clinical assessments.

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Area of Science:

  • Medical Imaging
  • Pediatric Radiology
  • Forensic Anthropology

Background:

  • The diagnostic utility of 3-D skull models in evaluating young children with suspected child abuse remains unclear.
  • Accurate diagnosis is critical in pediatric abuse cases to ensure appropriate intervention and care.

Purpose of the Study:

  • To evaluate the effectiveness of 3-D skull models as a problem-solving tool in pediatric patients under two years of age.
  • To determine if 3-D reconstructions improve the interpretation of head CT scans in cases of suspected abuse.

Main Methods:

  • A retrospective analysis was conducted on 73 children aged 0-24 months undergoing head CT.
  • Volume-rendered 3-D skull models were generated from CT data for children evaluated by a child protection team.
  • Data were collected between August 2007 and July 2009.

Main Results:

  • 3-D skull models were successfully created for 26 (35.6%) of the 73 children.
  • The 3-D models altered the initial CT interpretation in 9 instances (34.6%).
  • Specific findings included reclassification of suspected fractures as normal variants (4 cases), identification of ping-pong fractures (2 cases), confirmation of uncertain findings as fractures (1 case), and detection of additional fractures (1 case).

Conclusions:

  • Three-dimensional skull models serve as a valuable problem-solving tool when inconsistencies arise between CT interpretations, subsequent imaging, and clinical assessments.
  • The use of 3-D models can lead to changes in patient management, as demonstrated in five cases.
  • 3-D modeling enhances diagnostic accuracy in complex pediatric head trauma evaluations.