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Related Concept Videos

Sutures of the Skull01:22

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The human skull is composed of several bones that come together to protect the brain and support the structures of the face. The junctions where these bones meet are called sutures.
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The superior view of the cranium shows the frontal and paired parietal bones.
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The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
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State of the Art Cranial Ultrasound Imaging in Neonates
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Cranial Suture Evaluation on Routine Pediatric MRI.

Gayathri Sreedher1, Cassandra Gillespie2, Miraides Brown1

  • 1One Perkins Square, Akron Childrens Hospital, Akron, OH.

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|August 30, 2020
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Summary

Magnetic resonance imaging (MRI) is a reliable tool for evaluating cranial sutures, showing high accuracy in identifying patency or fusion. While CT scans offer better visibility, MRI provides accurate assessments when sutures are detected, especially in children.

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Area of Science:

  • Neuroradiology
  • Pediatric Imaging
  • Craniosynostosis Evaluation

Background:

  • Computed tomography (CT) with 3D reformats is the standard for imaging cranial sutures.
  • Magnetic resonance imaging (MRI) is typically used for evaluating brain malformations.
  • The reliability of MRI for direct suture evaluation is not well-established.

Purpose of the Study:

  • To assess the diagnostic accuracy and reliability of MRI in evaluating major cranial sutures.
  • To compare MRI findings of cranial sutures against CT scans.
  • To determine MRI's role in routine pediatric neuroimaging.

Main Methods:

  • Retrospective review of 500 pediatric patients with both MRI and CT scans within 3 months.
  • Two pediatric neuroradiologists independently assessed sagittal, coronal, and lambdoid sutures on MRI for patency or fusion.
  • CT scans were evaluated similarly, and results were compared to MRI for accuracy.

Main Results:

  • MRI correctly identified sutures in high percentages (sagittal: 98%, lambdoid: 99.6%, coronal: 100% when visualized).
  • Agreement between MRI and CT increased with patient age.
  • Visibility of sutures on MRI improved with age, while non-assessable sutures decreased.

Conclusions:

  • MRI is a viable tool for assessing cranial sutures, particularly the 3D T1-weighted sequence.
  • Despite lower visibility than CT, MRI is accurate for determining suture patency or fusion.
  • Routine inclusion of suture evaluation in pediatric neuro-MRIs is recommended due to potential neurocognitive impacts of synostosis.