Massimi L, Bianchi F, Frassanito P, Calandrelli R, Tamburrini G, Caldarelli M
Fondazione Policlinico Gemelli IRCCS, Neurochirurgia Infantile, Rome, Italy.
Università Cattolica del Sacro Cuore, Istituto Neurochirurgia, Rome, Italy.
Childs Nerv Syst. 2019 Nov;35(11):2055-2069. doi: 10.1007/s00381-019-04278-x. Epub 2019 Jul 9.
Currently, the interest on craniosynostosis in the clinical practice is raised by their increased frequency and their genetic implications other than by the still existing search of less invasive surgical techniques. These reasons, together with the problem of legal issues, make the need of a definite diagnosis for a crucial problem, even in single-suture craniosynostosis (SSC). Although the diagnosis of craniosynostosis is primarily the result of physical examination, craniometrics measuring, and observation of the skull deformity, the radiological assessment currently plays an important role in the confirmation of the diagnosis, the surgical planning, and even the postoperative follow-up. On the other hand, in infants, the use of radiation or the need of sedation/anesthesia raises the problem to reduce them to minimum to preserve such a delicate category of patient from their adverse effects.
METHODS, RESULTS AND CONCLUSIONS: This review aims at summarizing the state of the art of the role of radiology in craniosynostosis, mainly focusing on indications and techniques, to provide an update not only to pediatric neurosurgeons or maxillofacial surgeons but also to all the other specialists involved in their management, like neonatologists, pediatricians, clinical geneticists, and pediatric neurologists.
目前，临床实践中对颅缝早闭的关注不仅源于其发病率的增加及其遗传意义，还源于对侵入性较小的手术技术的持续探索。这些原因，再加上法律问题，使得即使在单缝颅缝早闭（SSC）中，明确诊断这一关键问题也变得十分必要。尽管颅缝早闭的诊断主要基于体格检查、颅骨测量以及对颅骨畸形的观察，但目前放射学评估在确诊、手术规划乃至术后随访中都发挥着重要作用。另一方面，对于婴儿而言，使用辐射或需要镇静/麻醉会引发将其危害降至最低的问题，以保护这类脆弱的患者免受不良影响。
方法、结果与结论：本综述旨在总结放射学在颅缝早闭中作用的最新进展情况，主要聚焦于适应症和技术，不仅为小儿神经外科医生或颌面外科医生，也为参与其治疗的所有其他专科医生（如新生儿科医生、儿科医生、临床遗传学家和小儿神经科医生）提供最新信息。
