Miller Carolyn, Losken H Wolfgang, Towbin Richard, Bowen A'Delbert, Mooney Mark P, Towbin Alex, Faix Richard S
Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Cleft Palate Craniofac J. 2002 Jan;39(1):73-80. doi: 10.1597/1545-1569_2002_039_0073_udoc_2.0.co_2.
To retrospectively study prenatal ultrasound images of patients with craniosynostosis to determine the extent to which prenatal diagnosis is possible.
Prenatal ultrasound images of 19 patients with postnatally diagnosed metopic or coronal suture craniosynostosis were retrospectively reviewed. The 26 ultrasound examinations obtained were compared with normal images and tables of gestation.
It was not possible to diagnose craniosynostosis in the first trimester. In the second trimester, Kleeblattschädel was diagnosed at 20.5 weeks. A multilobular shape to the skull and diastasis of the frontotemporal suture was identified. In a second child with Kleeblattschädel, the cephalic index was above normal 86.4 (normal range 70 to 86), and the head circumference to abdominal circumference was increased. In the third trimester, the head shape deformation was more obvious. Brachycephaly diagnosis was made in the second trimester. In Crouzon syndrome the hypertelorism was identified at 19.9 weeks. Plagiocephaly was diagnosed at 21.4 weeks. In trigonocephaly the reduced cephalic index was noted at 18.8 weeks. In the third trimester, the deformity was diagnosed in all cases.
No diagnosis of craniosynostosis was made in the first trimester. In the second trimester, it was possible to diagnose Kleeblattschädel, trigonocephaly, brachycephaly (bilateral coronal suture craniosynostosis), and plagiocephaly (unilateral coronal suture craniosynostosis) in nine of the examinations. In the third trimester and at term, it was possible to diagnose previously listed conditions from six of the seven examinations obtained. Kleeblattschädel was suspected during original examination. A total of 15 examinations of 26 were correctly diagnosed during this investigation.
回顾性研究颅缝早闭患者的产前超声图像，以确定产前诊断的可能性。
回顾性分析19例产后诊断为冠状缝或矢状缝颅缝早闭患者的产前超声图像。将获得的26次超声检查结果与正常图像及孕周表进行比较。
孕早期无法诊断颅缝早闭。孕中期，在20.5周时诊断出短头畸形。发现颅骨呈多叶状以及额颞缝增宽。在另一名患有短头畸形的儿童中，头指数高于正常的86.4（正常范围70至86），头围与腹围之比增加。孕晚期，头部形状变形更明显。在孕中期诊断出短头畸形。在克鲁宗综合征中，19.9周时发现两眼间距增宽。21.4周时诊断出斜头畸形。在三角头畸形中，18.8周时注意到头指数降低。孕晚期，所有病例均诊断出畸形。
孕早期未诊断出颅缝早闭。孕中期，在26次检查中的9次检查中诊断出短头畸形、三角头畸形、短头畸形（双侧冠状缝颅缝早闭）和斜头畸形（单侧冠状缝颅缝早闭）。孕晚期及足月时，在获得的7次检查中的6次检查中诊断出上述疾病。在最初检查时怀疑有短头畸形。在本次研究中，26次检查中有15次检查被正确诊断。
