Purpose or Case Report: Craniosynostosis is the premature fusion of one or more cranial sutures, leading to deformed head shape, increased intracranial pressure and restricted brain growth. The most reliable diagnostic method to use is computed tomography (3D–CT). Aim of this study was to present the characteristics of children with craniosynostosis and to compare US findings with 3D–CT as “gold standard”.
Methods & Materials: Cross–sectional study was performed on 225 children suspected of craniosynostosis. All the children were examined using US evaluation of cranial sutures and 3D–CT at the University children’s hospital, Belgrade, in the three–year period. We analysed: gender, age, number of births, gestation week on birth (GW), body weight on birth (BW), difficult delivery (forceps, vacuum), presence of the syndromes, circumference of the head, size of the large fontanelle and head shape. Statistical analysis was done in SPSS 20.0.
Results: Craniosynostosis was confirmed by 3D–CT in 197 (87%) cases, with M:F ratio being 2:1. Diagnosis was confirmed in the period between 5^th and 6^th month of age in 24% cases and in 3% newborns. 47% patients were firstborns. Mean value of GW was 37,5±2,6 and mean BW was 3026±765 g. In 8% of cases the delivery was completed with forceps or vacuum. There were no children with syndromic craniosynostosis. Mean value of the head circumference was 35±2,5 cm, and mean size of the large fontanelle was 1,1±0,2 x 0,7±0,1 cm. 40% patients had dolihocephaly. Brachycephaly was present in 22%, plagiocephaly and trigoncephaly in 18% and 17% cases. The most frequent was sagittal (24%) and metopic (21%) craniosynostosis individually, followed by bicoronal and bilambdoid in 16%, while the most rare was the combination of sagittal and bicoronal fusion in 2% cases. In 42% of cases the existence of craniosynostosis was confirmed by US, from which 68% had sagittal craniosynostosis, individually or in combination with the other fusions. Bicoronal and bilambdoid fusions were not recognized at US.
Conclusions: In our cohort children with craniosynostosis was in most cases male, firstborns, with a slightly smaller head circumference and large fontanelle, with dolihocephalic head shape and sagittal or metopic fusion. In addition to the 3D–CT, US evaluation of cranial sutures can be used, especially in the case of sagittal stenosis. Thus it can be avoided unnecessary radiation of children.