Imaging in Craniofacial Disorders With Special Emphasis on Gradient Echo Black-Bone and Zero Time Echo MRI Sequences

Area of Science:

• Medical Imaging
• Pediatric Neurosurgery
• Radiology

Background:

• Ionizing radiation from CT scans prompts a shift towards non-ionizing imaging like MRI.
• Pediatric neurosurgery benefits from MRI, but CT remains superior for bone imaging in craniofacial disorders.
• Craniosynostosis assessment requires precise bone imaging for surgical planning.

Purpose of the Study:

• To review existing knowledge on using MRI as a substitute for CT in craniosynostosis assessment.
• To identify studies and trials evaluating MRI's accuracy for bone imaging in pediatric craniosynostosis.

Main Methods:

• A scoping review of literature from major databases (PubMed, Scopus, etc.) and ClinicalTrials.gov.
• Inclusion criteria focused on Gradient Echo Black-Bone (BB) and Zero Time Echo (ZTE) MRI sequences for pediatric craniosynostosis preoperative planning.
• Screened 492 records and retrieved 55 from clinical trial registries.

Main Results:

• Five clinical studies reported high accuracy for MRI-based 3D bone reconstruction in pediatric craniosynostosis.
• Limited evidence (Level IV) supports BB and ZTE MRI for surgical planning in craniosynostosis.
• Two ongoing randomized clinical trials are expected to provide further insights.

Conclusions:

• MRI techniques like BB and ZTE show potential for accurate bone imaging in pediatric craniosynostosis.
• Further high-quality evidence is required to establish MRI as a reliable alternative to CT for surgical planning.
• Ongoing clinical trials are crucial for determining the role of advanced MRI sequences in craniosynostosis management.