Comparison of Black Bone MRI and 3D-CT in the preoperative evaluation of patients with craniosynostosis
Comparison of Black Bone MRI and 3D-CT in the preoperative evaluation of patients with craniosynostosis
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DOI：
10.1016/j.bjps.2019.11.006
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发表时间：
2020-04-01
影响因子：
2.7
通讯作者：
Brandstack, Nina
中科院分区：
文献类型：
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作者：
Saarikko, Anne;Mellanen, Eero;Brandstack, Nina
目的：黑骨(BB)磁共振成像(MRI)是一种非电离成像方法，是近年来替代CT检查颅脑畸形的一种新方法。本研究的目的是比较BB-MRI和常规3D-CT在颅缝融合患者术前评估中的作用。方法：本中心对临床怀疑颅缝融合的患者常规行术前头颅CT和颅脑MRI检查。我们最近改变了我们的MRI方案，包括通过BB-MRI评估大脑解剖和头盖骨和缝合的序列。为了便于可视化，提出了一种半自动的颅骨分割算法。对9例临床诊断为颅脑融合的患者进行了BB-MRI和3D-CT检查，并由2名颅面外科医生、1名儿科神经外科医生和2名神经放射科医生对图像进行了评价。舟头畸形6例(6/9)，单冠融合1例(1/9)，板样融合2例(2/9)。所有患者均可通过BB-MRI和3D-CT识别受影响的滑膜缝线。评分员内和评分员间对颅骨缝合进行评分的可靠性很高。结论：BB-MRI可替代3D-CT用于颅缝融合患者的术前评估。BB-MRI不仅提供有关颅缝和颅内印记的信息，而且在一次成像过程中还提供关于大脑结构的信息。该方法可以替代基于电离辐射的颅骨畸形分析方法。(C)2019年英国整形、重建和美容外科医生协会。爱思唯尔有限公司出版。保留所有权利。
Purpose: Black Bone (BB) magnetic resonance imaging (MRI) is a nonionizing imaging method and a recent alternative to computed tomography (CT) in the examination of cranial deformities. The purpose of this study was to compare BB-MRI and routine 3D-CT in the preoperative evaluation of patients with craniosynostosis.Methods: At our center, we have routinely performed preoperative CT of the skull and brain MRI for patients with clinical suspicion of craniosynostosis. We recently changed our MRI protocol into one that includes sequences for the evaluation of both brain anatomy and skull bone and sutures by BB-MRI. A semi-automatic skull segmentation algorithm was developed to facilitate visualization. Both BB-MRI and 3D-CT were performed on 9 patients with clinical craniosynostosis, and the images were evaluated by two craniofacial surgeons, one pediatric neurosurgeon, and two neuroradiologists.Results: We obtained informative 3D images using BB-MRI. Six (6/9) patients had scaphocephaly, 1 (1/9) patient had unicoronal synostosis, and 2 (2/9) patients had lambdoid synostosis. The affected synostotic sutures could be identified both by BB-MRI and by 3D-CT in all patients. Intra-rater and inter-rater reliability for rating the calvarial sutures was high. However, the reliability for rating the intracranial impressions was low by both imaging methods.Conclusion: BB-MRI is an alternative to 3D-CT in the preoperative evaluation of patients with craniosynostosis. BB-MRI provides information not only on cranial sutures and intracranial impressions but also on the brain structure in one imaging session. This method can replace ionizing radiation-based methods in analyzing skull deformities. (C) 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.