骨化性头皮血肿影像学表现的时间演变

Kandemirli Sedat Giray, Cingoz Mehmet, Bilgin Cem, Olmaz Burak

Uludag University Faculty of Medicine, Department of Radiology, Bursa, Turkey.

University of Iowa Hospital and Clinics, Department of Radiology, Iowa City, IA.

J Craniofac Surg. 2020 Jun;31(4):e375-e378. doi: 10.1097/SCS.0000000000006319.

BACKGROUND

Cephalohematoma is collection of blood between skull and periosteum that is confined by cranial sutures. Cephalohematomas usually resorb spontaneously within the first month of life; however, if it fails to resolve, ossified cephalohematoma may form.

METHODS

Clinical archiving system and picture archiving and communication system were retrospectively reviewed for cases of birth-related cephalohematoma. Cases of ossified cephalohematomas identified on imaging were retrieved from this subset of patients. Cross-sectional imaging findings in patients with ossified cephalohematomas were evaluated for location, size of the hematoma, and contours of the inner lamella.

RESULTS

Out of 115 cases of cephalohematoma, 7 cases had imaging findings consistent with ossified cephalohematoma. All ossified cephalohematomas were located parietally, with size ranging between 18 and 55 mm and the thickness of the outer rim of calcification ranging between 1.5 and 4.8 mm. The contour of inner lamella in relation to the surrounding normal cranial vault was normal in 5 cases, and inner lamella was depressed in 2 cases.Three patients had follow-up imaging available for demonstration of changes in ossified cephalohematoma. The first case was an 11 day-old boy with a cephalohematoma with no signs of calcification at the time of initial imaging. Follow-up at 2 months of age showed partial regression of hematoma cavity with marked calcification at the hematoma walls. The second case was a 3 month-old boy with ossified cephalohematoma at initial imaging. Follow-up imaging at 7 months of age showed almost total regression of hematoma cavity, and approximation of inner and outer lamella with increased thickness of the cranial vault. The third case was a 1 month-old boy with ossified cephalohematoma at initial imaging that totally resolved without residual increased bone thickness at 21-month follow-up.

CONCLUSION

These 3 cases demonstrate the variability in temporal changes that may occur in ossified cephalohematomas.

背景

头颅血肿是指颅骨与骨膜之间的血液积聚，其范围受颅缝限制。头颅血肿通常在出生后的第一个月内自行吸收；然而，如果未能消退，可能会形成骨化性头颅血肿。

方法

对临床存档系统和图像存档与通信系统进行回顾性分析，以查找与出生相关的头颅血肿病例。从该患者子集中检索出影像学检查发现骨化性头颅血肿的病例。对骨化性头颅血肿患者的横断面影像学表现进行评估，包括血肿的位置、大小以及内层骨板的轮廓。

结果

在115例头颅血肿病例中，有7例的影像学表现符合骨化性头颅血肿。所有骨化性头颅血肿均位于顶叶，大小在18至55毫米之间，钙化外缘厚度在1.5至4.8毫米之间。5例患者的内层骨板相对于周围正常颅顶轮廓正常，2例患者的内层骨板凹陷。3例患者有随访影像学检查，以显示骨化性头颅血肿的变化。第一例是一名11日龄男婴，初次影像学检查时头颅血肿无钙化迹象。2个月龄时的随访显示血肿腔部分消退，血肿壁有明显钙化。第二例是一名3个月龄男婴，初次影像学检查时有骨化性头颅血肿。7个月龄时的随访影像学检查显示血肿腔几乎完全消退，内层和外层骨板接近，颅顶厚度增加。第三例是一名1个月龄男婴，初次影像学检查时有骨化性头颅血肿，21个月随访时完全消退，无残留骨厚度增加。