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Updated: Mar 7, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Effectiveness of screening for craniosynostosis with ultrasound: a retrospective review
Kent M Hall1, David A Besachio2, Matthew D Moore2
1Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA, 23708, USA. hallkenm@gmail.com.
Insights
Cranial ultrasound effectively screens for craniosynostosis in infants with abnormal head shapes. This imaging method accurately rules out premature suture closure, avoiding unnecessary radiation exposure from CT scans.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Craniosynostosis Diagnosis
Background:
- Minimizing ionizing radiation in pediatric radiology is crucial.
- Computed tomography (CT) is standard for craniosynostosis but involves radiation.
- Alternative screening methods are needed to reduce radiation exposure in children.
Purpose of the Study:
- To evaluate sonography (US) of cranial sutures as a screening tool.
- To determine if US can adequately diagnose craniosynostosis in infants with abnormal head shapes.
- To assess the accuracy of US in identifying premature suture closure.
Main Methods:
- Retrospective review of cranial suture ultrasound (US) examinations.
- Comparison of US results with clinical follow-up and/or head CT.
- Analysis of 52 adequate sonographic exams performed between July 2012 and September 2015.
Main Results:
- Cranial US demonstrated 100% sensitivity, specificity, and negative predictive value for craniosynostosis.
- All seven cases with US-diagnosed synostosis were confirmed by CT or operative reports.
- Forty-five cases without synostosis on US were also confirmed by follow-up, ruling out premature closure.
Conclusions:
- Cranial ultrasound is a reliable screening tool for craniosynostosis.
- US can effectively rule out premature suture closure in infants with abnormal head shapes.
- This modality offers a radiation-free alternative for initial screening.
Background:
Minimizing the ionizing radiation dose to children is fundamental to pediatric radiology. The most widely accepted imaging examination for evaluating craniosynostosis is computed tomography (CT) of the head, an examination that involves ionizing radiation.
Objective:
To determine if sonography of the cranial sutures is an adequate screening examination for the diagnosis of craniosynostosis in patients with abnormal skull shape.
Materials And Methods:
A retrospective review of all cranial suture ultrasound (US) examinations performed during the course of a 3-year period (July 2012 - September 2015) was undertaken. Results were compared with clinical follow-up and/or head CT to evaluate the accuracy of this modality as a screening tool to determine the presence or absence of craniosynostosis. Fifty-two sonographic exams were adequate for inclusion.
Results:
Forty-five of the examinations did not reveal synostosis. In each of these instances, follow-up physical exam findings and/or CT imaging confirmed that no abnormal premature suture closure was present. US findings demonstrated synostosis in seven cases. CT exam or operative reports of these cases confirmed all seven findings of premature suture closure. Statistical analysis demonstrated a sensitivity of 100% (95% confidence interval [CI]: 56.1-100.0%), a specificity of 100% (95% CI: 90.2-100.0%), and a negative predictive value of 100% (95% CI: 90.2-100.0%).
Conclusion:
Cranial US is a reliable screening tool to rule out craniosynostosis in patients with abnormal head shape.
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