University of Bern, Institute for Surgical Technology and Biomechanics, Stauffacherstr. 78, 3014, Bern, Switzerland.
J Pediatr Surg. 2011 Oct;46(10):E1-8. doi: 10.1016/j.jpedsurg.2011.04.095.
Craniosynostosis consists of a premature fusion of the sutures in an infant skull that restricts skull and brain growth. During the last decades, there has been a rapid increase of fundamentally diverse surgical treatment methods. At present, the surgical outcome has been assessed using global variables such as cephalic index, head circumference, and intracranial volume. However, these variables have failed in describing the local deformations and morphological changes that may have a role in the neurologic disorders observed in the patients. This report describes a rigid image registration-based method to evaluate outcomes of craniosynostosis surgical treatments, local quantification of head growth, and indirect intracranial volume change measurements. The developed semiautomatic analysis method was applied to computed tomography data sets of a 5-month-old boy with sagittal craniosynostosis who underwent expansion of the posterior skull with cranioplasty. Quantification of the local changes between pre- and postoperative images was quantified by mapping the minimum distance of individual points from the preoperative to the postoperative surface meshes, and indirect intracranial volume changes were estimated. The proposed methodology can provide the surgeon a tool for the quantitative evaluation of surgical procedures and detection of abnormalities of the infant skull and its development.
颅缝早闭是指婴儿颅骨中的缝线过早融合，从而限制颅骨和大脑的生长。在过去几十年中，出现了许多根本不同的手术治疗方法。目前，手术效果是使用头围指数、头围和颅内体积等全局变量来评估的。然而，这些变量在描述局部变形和形态变化方面存在不足，而这些变化可能与患者中观察到的神经紊乱有关。本报告描述了一种基于刚性图像配准的方法，用于评估颅缝早闭手术治疗的结果、局部头围生长的定量评估以及间接颅内体积变化的测量。所开发的半自动分析方法应用于一位 5 个月大的矢状缝颅缝早闭男孩的计算机断层扫描数据集，该男孩接受了颅骨成形术来扩大颅后。通过将术前表面网格中各个点到术后表面网格的最小距离映射来量化术前和术后图像之间的局部变化，并估计间接颅内体积变化。所提出的方法可以为外科医生提供一种工具，用于对手术过程进行定量评估，并检测婴儿颅骨及其发育的异常。
