CT头面部三维重建在颅缝早闭中的诊断价值

Value of CT head facial 3D reconstruction in diagnosis of craniosynostosis

目的探讨CT头面部三维重建在婴幼儿颅缝早闭中的诊断价值及影像特征。方法收集头颅外形明显异常及头围小于参考值两个标准差、临床高度怀疑颅缝早闭的患儿25例,进行CT容积扫描并行头面部三维重建,分析各颅缝闭合情况、头颅外形异常及其并发征象。结果 25例颅缝早闭患儿中,额缝早闭7例,矢状缝早闭6例,右侧冠状缝早闭1例,左侧冠状缝及人字缝早闭2例,双侧冠状缝闭合5例,各缝均早闭4例,在CT头面部三维重建中表现为早闭颅缝处骨质堆积、增厚,颅缝显示模糊不清、狭窄、部分或者完全消失。其中7例患儿颅骨内板呈花边样压迹,7例脑实质发育不良,1例左侧额叶小软化灶,1例双侧颞部蛛网膜囊肿。结论 CT头面部三维重建可以清楚、全方位地显示颅缝早闭、头颅外形及脑内结构,使诊断更加直观、清晰,有利于临床治疗。

Objective To investigate the diagnostic value of CT head facial 3D reconstruction in infants and young children and the imaging features of craniosynostosis. Methods Twenty-five children,who had obviously abnormal head shape and head circumference lower than a reference value by 2 standard deviations and were highly suspected of craniosynostosis,were selected for CT head facial 3D reconstruction.The cranial suture closed situation, head shape abnormality and complications were analyzed.Results Among 25 children with craniosynostosis,there were 7 cases of frontal suture closed early,6 cases of sagittal suture closed early,1 case of right-side coronal suture closed early,2 cases of left-side coronal suture and herringbone stitch closed early,5 cases of bilateral coronal suture closed,and 4 cases of all sutures closed early. The images showed that the bone was accumulated in the early closed cranial suture,and the cranial suture was indistinct,narrow,and partially or completely disappeared. There were 7 cases of skull plate with lacy pressure trace,7 cases of parenchymal dysplasia,1 case of left frontal lobe little softening oven,and 1 case of bilateral temporal arachnoid cysts. Conclusion CT head facial 3D reconstruction can clearly and all-roundly display craniosynostosis,head shape and brain structure,and make the diagnosis be more intuitive and accurate. It is helpful to clinical treatment.