儿童狭颅症的X线和MRI诊断

On X-ray and MRI Diagnosis of Children Craniostenosis

目的探讨狭颅症的X线和MRI表现特点及其各自的诊断优势。方法回顾性分析4例狭颅症患者的临床资料及影像学表现,包括X线和MRI。结果 4例狭颅症,1例表现为小头畸形,1例表现为尖头畸形,2例表现为短头畸形。4例均可见局部脑回压迹加深。2例短头畸形可见冠状缝闭合,前颅窝变浅,双侧眶顶上抬,眼眶变浅并眼球突出。其中1例短头畸形合并并指畸形。MR示双侧额叶体积较小、脑左右径增大,前后径较小,蝶鞍扩大,垂体低矮。1例尖头畸形X表现为顶部脑回样深压迹,MR显示局部脑组织沿变薄的颅板膨隆、突起。结论狭颅症的X线平片有显著的特点,具有可靠的价值,MRI可明确显示继发征象,如脑组织及眼眶、眼球等的异常,与X线平片互为补充。

Objective To explore the X-ray ,CT and MRI features and their respective advantages in the diagnosis of craniostenosis. Methods＇ X-ray examination was performed on four children and two of them received MR scans. The clinical information and imaging data of the four cases were retrospectively reviewed. Methods X-ray examination was performed on four children and two of them received MR scans. The clinical information and imaging data of the four cases were retrospectively reviewed. Results Of the four cases, microcephaly and acrocephaly were shown in two cases respectively. Brachycephaly was shown in 2 cases. Four cases demonstrated very conspicuous gyral impression. Coronal synostosis, shallow anterior cranial fossa, shallow orbits, uplifting of the orbital roof and exophthalmos were found in the two brachycephaly cases. Syndactyly was complicated in one of the brachycephaly cases. Both of the two brachycephaly demonstrated small frontal lobe, accrescent transverse diameter, small anteroposterior diameter, expanded sella and lowered pituitary gland on MR images. One case with acrocephaly demonstrated deep convolutional markings in parietal bone and the bilateral frontal lobe grew protrusion along the thinning cranial bone on MR images. Conclusions The significant features of craniostenosis on X-ray plain film make the diagnosis reliable. The secondary signs can be clearly demonstrated on MRI, such as abnormalities of the brain, orbital and eyes, etc. , so MRI is complementary with the X-ray plain film in the diagnosis of craniostenosis.