Çalışkan S, Oğuz K K, Tunalı S, Aldur M M, Erçakmak B, Sargon M F
Folia Morphol (Warsz). 2018;77(4):730-735. doi: 10.5603/FM.a2018.0030. Epub 2018 Mar 23.
As far as our literature searches showed us, morphological characteristics of cranium such as sutures, sutural bones and fontanelles had been examined in the skulls in the museums and dry specimens until now. As a modern method, three-dimensional virtual reconstruction of cranial bones by using multidetector computed tomography-computed tomography angiography (MDCT-CTA) can display in vivo morphological characteristics. In our study, we aimed to determine the presence and incidence of these morphological characteristics that can be clinically significant in our population, by using radiologic methods.
We examined head and neck regions of 185 patients via MDCT-CTA. We evaluated radiologically detectable variations of the metopic sutures, lambda, bregma, asterion and pterion, which can be very easily confused with fractures. Additionally, the differences between the genders and incidence of coexistence of these variations were evaluated.
According to our study, the incidence of persistent metopic suture was 8.1% and the incidence of lambda variations was 5.9%. Variations were most commonly encountered on the left asterion, and least commonly on the bregma and left pterion. In the evaluation of the coexistence of the parameters and combinations, the Wormian bones located at the right and left asterions were detected. There were no statistically significant differences between genders.
Variations of the sutures and sutural bones can be easily misdiagnosed with the fractures of related bony regions in unconscious patients with multiple traumas. During surgical interventions in these patients, surgeons must take this fact into consideration in order to make differential diagnosis of fractures and intersutural bone variations.
就我们的文献检索结果而言，颅骨的形态学特征，如缝、缝间骨和囟门，迄今为止都是在博物馆的头骨和干燥标本中进行研究的。作为一种现代方法，利用多排螺旋计算机断层扫描 - 计算机断层血管造影（MDCT - CTA）对颅骨进行三维虚拟重建能够显示活体的形态学特征。在我们的研究中，我们旨在通过放射学方法确定这些在我们的研究人群中可能具有临床意义的形态学特征的存在情况和发生率。
我们通过MDCT - CTA检查了185例患者的头颈部区域。我们对额缝、枕外隆凸、前囟、星点和翼点等在放射学上可检测到的变异进行了评估，这些变异很容易与骨折混淆。此外，还评估了这些变异在性别上的差异以及共存的发生率。
根据我们的研究，持续存在的额缝发生率为8.1%，枕外隆凸变异的发生率为5.9%。变异最常出现在左侧星点，最不常出现在前囟和左侧翼点。在对参数及其组合的共存情况进行评估时，检测到位于左右星点的缝间骨。性别之间没有统计学上的显著差异。
在患有多处创伤的昏迷患者中，缝和缝间骨的变异很容易被误诊为相关骨区域的骨折。在对这些患者进行手术干预时，外科医生必须考虑到这一事实，以便对骨折和缝间骨变异进行鉴别诊断。
