Cranial sutures ultrasonography as a valid diagnostic tool in isolated craniosynostoses: A pilot study

Background: Craniosynostoses are the most frequent craniofacial malformations. Diagnosis has for long time relied on standard radiographs, and still nowadays, they are of first step in the evaluation of suspected craniosynostosis. CT and MRI scans are also valuable tools for further diagnostics in craniosynostoses, but they expose the children to a large amount of radiation or they require sedation due to scarce patient compliance. The value of ultrasound as a screening tool for craniosynostosis remains non-established, but it offers a non-expensive, non-risky, and fast mean of detection for sutural growth impairment. The aim of this study is to demonstrate the effectiveness of the use of ultrasound as a diagnostic and follow-up tool in newborn children affected by craniostenoses. Methods: We have selected 17 children, whose clinical findings were clinically suggestive for craniostenosis or head molding. All patients underwent an ultrasound examination, and those positive for craniostenosis or with an uncertain diagnosis also underwent CT scan examination. All patients positive for craniosynostosis and patients in which diagnosis was still unsure also underwent a CT scan examination for further confirmations; results from CT scan were then compared to those obtained with ultrasound examinations. Results: Five infants had normal appearance of the cranial sutures on US. In 12/17 infants, US identified premature closure of one or more cranial sutures in particular. Results from CT scan compared to those obtained with US examinations showed a 100 % match between the two techniques. Conclusions: In our experience, ultrasound examination has shown to be an effective, fast, inexpensive, and non-risky method for diagnosis and assessments in children with craniostenoses and was able to detect the presence of synostosis in all patients affected with a 100 % match with CT scan examination. Level of Evidence: Level III, diagnostic study. © 2013 Springer-Verlag Berlin Heidelberg.