Leikola Junnu, Koljonen Virve, Heliövaara Arja, Hukki Jyri, Koivikko Mika
Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Central Hospital, Helsinki, Finland,
Childs Nerv Syst. 2014 Dec;30(12):2097-102. doi: 10.1007/s00381-014-2456-x. Epub 2014 Jun 26.
This study aims to compare pre- and postoperative cephalic indexes (CI) with corresponding segmented intracranial volumes (SIV) obtained from volumetric CT in scaphocephalic patients.
Twenty-four patients (17 boys) who had undergone cranial vault remodeling due to scaphocephaly were compared from 3D-CT imaging datasets. The mean age of the patients at preoperative CT imaging was 5.5 months, and that at 1-year postoperative imaging, 21.5 months. The mean interval between preoperative CT imaging and surgery was 3.3 months. Pearson's correlation was used to test the correlation of both pre- and postoperative CI with SIV. A paired t test was used to compare differences in the pre- and postoperative mean values of CI and SIV.
CI correlated poorly with intracranial volume both preoperatively (r = 0.274) and postoperatively (r = 0.128). The mean preoperative CI was 65.92 (range 57.99-73.97), and the mean postoperative, CI 70.24 (range 60.23-75.57). The mean preoperative intracranial volume was 877.79 cm(3) (range 638-1,256), and the 1-year postoperative volume, 1,249.04 cm(3) (range 1,039-1,529). The mean values of both CI and SIV increased significantly after surgery. In one patient, the CI in postoperative measurements was smaller, whereas in all patients, the postoperative SIV was larger than the preoperative intracranial volume. The mean percentage increase in CI was 6.6 %, whereas the mean increase in SIV was 43.1 %.
Cephalic index correlates poorly with intracranial volume in non-syndromic scaphocephalic patients. For some patients, surgery and growth resulted in only subtle or no change in CI despite a notable increase in intracranial volume.
本研究旨在比较舟状头畸形患者术前和术后的头指数（CI）与从容积CT获得的相应分割颅内体积（SIV）。
从3D-CT成像数据集中比较24例因舟状头畸形接受颅盖重塑手术的患者（17名男性）。术前CT成像时患者的平均年龄为5.5个月，术后1年成像时为21.5个月。术前CT成像与手术之间的平均间隔为3.3个月。采用Pearson相关性检验术前和术后CI与SIV的相关性。采用配对t检验比较CI和SIV术前和术后平均值的差异。
CI与颅内体积在术前（r = 0.274）和术后（r = 0.128）的相关性均较差。术前CI的平均值为65.92（范围57.99 - 73.97），术后CI的平均值为70.24（范围60.23 - 75.57）。术前颅内体积的平均值为877.79 cm³（范围638 - 1256），术后1年的体积为1249.04 cm³（范围1039 - 1529）。手术后脑指数（CI）和分割颅内体积（SIV）的平均值均显著增加。1例患者术后测量的CI较小，而所有患者术后的SIV均大于术前颅内体积。CI的平均增加百分比为6.6%，而SIV的平均增加为43.1%。
在非综合征性舟状头畸形患者中，头指数与颅内体积的相关性较差。对于一些患者，尽管颅内体积显著增加，但手术和生长仅导致CI有细微变化或无变化。
