Sanati-Mehrizy Paymon, Graziano Francis D, Naidich Thomas, Taub Peter J
Division of Plastic and Reconstructive Surgery.
Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.
J Craniofac Surg. 2020 May/Jun;31(3):e288-e291. doi: 10.1097/SCS.0000000000006241.
Bilateral parietal thinning (BPT) of the calvarium is uncommon but can lead to significant morbidity, including pain or communication through the thinned bone. This study aimed to define and characterize a novel grading system for BPT.
Coronal CT scans of patients with BPT were retrospectively analyzed and anatomic measurements were taken including (1) thinning ratio, defined as calvarial thickness at the thinnest point divided by the average thickness of the surrounding bone and (2) width of the defect. In addition, patient demographics and comorbidities were collected.
Forty-three patients were identified with BPT, with an average age of 73 ± 16 years and 74% were female. The authors' novel grading scheme based on depth of calvarium involvement was found to be significantly correlated to thinning ratio (P < 0.001) and width (P < 0.001). When controlling for comorbidities, increasing age (P = 0.044) was the only significant independent risk factor associated with thinning ratio. With respect to defect size, when controlling for comorbidities, both hypertension (P = 0.025) and increasing age (P = 0.024) were found to be significant independent risk factors related to increasing defect size. Twenty patients (47%) had multiple CT scans (range 5 month-5 year interval). In this group, patients had an average of 0.66 ± 0.11 mm decrease in parietal thickness per each year of increasing age, showing progressive parietal thinning with time.
This study proposes a novel quantitatively-characterized grading scheme for BPT. The authors' results indicate that when controlling for comorbidities, BPT thinning is associated with increasing age, while defect width is associated with increasing age and hypertension. This grading scheme can help to diagnose, classify, and monitor patients with parietal bone thinning.
颅骨双侧顶骨变薄（BPT）并不常见，但可导致严重的发病情况，包括疼痛或通过变薄的骨质进行交流。本研究旨在定义并描述一种针对BPT的新型分级系统。
对BPT患者的冠状位CT扫描进行回顾性分析，并进行解剖学测量，包括（1）变薄率，定义为最薄点处的颅骨厚度除以周围骨质的平均厚度，以及（2）缺损宽度。此外，收集患者的人口统计学数据和合并症。
共识别出43例BPT患者，平均年龄为73±16岁，74%为女性。基于颅骨受累深度的作者新型分级方案被发现与变薄率（P<0.001）和宽度（P<0.001）显著相关。在控制合并症时，年龄增加（P=0.044）是与变薄率相关的唯一显著独立危险因素。关于缺损大小，在控制合并症时，高血压（P=0.025）和年龄增加（P=0.024）均被发现是与缺损大小增加相关的显著独立危险因素。20例患者（47%）进行了多次CT扫描（间隔时间为5个月至5年）。在该组中，患者年龄每增加一岁，顶骨厚度平均减少0.66±0.11mm，显示顶骨随时间逐渐变薄。
本研究提出了一种针对BPT的新型定量特征分级方案。作者的结果表明，在控制合并症时，BPT变薄与年龄增加有关，而缺损宽度与年龄增加和高血压有关。这种分级方案有助于诊断、分类和监测顶骨变薄的患者。
