Miyabayashi Hiroshi, Nagano Nobuhiko, Kato Risa, Noto Takanori, Hashimoto Shin, Saito Katsuya, Morioka Ichiro
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan.
Department of Pediatrics, Kasukabe Medical Center, Saitama 344-8588, Japan.
J Clin Med. 2022 Mar 24;11(7):1797. doi: 10.3390/jcm11071797.
In this study, we aimed to monitor changes in cranial shape using three-dimensional (3D) scanning to determine whether the severity of deformational plagiocephaly (DP) at the age of 6 months could be predicted at the age of 1 month. The cranial shape was measured at the ages of 1, 3, and 6 months (T1, T2, and T3, respectively) in 92 infants. We excluded those who received helmet treatment before T3. The cranial vault asymmetry index (CVAI) using 3D scanning was evaluated in all infants. DP was defined as a CVAI > 5.0% with mild (CVAI ≤ 6.25%) or moderate/severe severity (CVAI > 6.25%). The CVAI cut-off value at T1 for severe DP at T3 was determined using receiver operating characteristic (ROC) curves. At T1, T2, and T3, the respective CVAI median values were 5.0%, 5.8%, and 4.7% and the DP incidence was 50.0%, 56.8%, and 43.2%, respectively. The DP severity temporarily worsened from T1 to T2 but then improved at T3. Among the infants, 73.9% had a similar DP severity at T1 and T3 (p = 1.0). A ROC curve analysis revealed a CVAI cut-off value of 7.8% at T1 predicted severe DP. It was concluded that later DP severity could be predicted using 3D scanning at T1 with properly defined cut-off values.
在本研究中，我们旨在通过三维（3D）扫描监测颅骨形状的变化，以确定1月龄时能否预测6月龄时变形性斜头畸形（DP）的严重程度。对92例婴儿在1、3、6月龄时（分别为T1、T2和T3）测量颅骨形状。我们排除了在T3之前接受头盔治疗的婴儿。对所有婴儿评估使用3D扫描的颅顶不对称指数（CVAI）。DP定义为CVAI>5.0%，分为轻度（CVAI≤6.25%）或中度/重度（CVAI>6.25%）。使用受试者工作特征（ROC）曲线确定T1时预测T3时严重DP的CVAI临界值。在T1、T2和T3时，CVAI的中位数分别为5.0%、5.8%和4.7%，DP发病率分别为50.0%、56.8%和43.2%。DP严重程度从T1到T2暂时加重，但在T3时有所改善。在这些婴儿中，73.9%在T1和T3时DP严重程度相似（p = 1.0）。ROC曲线分析显示，T1时CVAI临界值为7.8%可预测严重DP。得出的结论是，使用T1时的3D扫描及适当定义的临界值可以预测后期DP的严重程度。
