Ganau Mario, Syrmos Nikolaos C, Magdum Shailendra A
Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
Department of Neurosurgery, Aristotle University of Thessaloniki, Macedonia, Greece.
J Pediatr Neurosci. 2022 Sep;17(Suppl 1):S14-S20. doi: 10.4103/jpn.JPN_46_22. Epub 2022 Sep 19.
The well-known effects of ionizing radiation on brain cells have been a major driving force toward the use of non-ionizing methods of imaging in both elective and emergency settings. Pediatric neurosurgery has certainly leveraged on this shift in clinical practice, however patients with craniofacial disorders could not fully benefit from the adoption of magnetic resonance imaging (MRI) because computed tomography (CT) scans still retain superior imaging power on bone tissue.
To explore the knowledge available on the use of MRI as surrogate for CT scan in the assessment of craniosynostosis.
A scoping review was designed to identify landmark studies and ongoing clinical trials exploring the accuracy of MRI-based bone imaging in the preoperative planning of pediatric patients with craniosynostosis.
A total of 492 records were screened from Pubmed, Ovid Medline, Scopus, and Cochrane Library databases; while 55 records were retrieved from ClinicalTrials.gov register. Only clinical studies revolving around the use of Gradient Echo Black-Bone (BB) and Zero Time Echo (ZTE) MRI sequences for the preoperative planning of pediatric craniosynostosis were retained for inclusion.
This review identified only five clinical studies reporting a high accuracy of MRI-based 3D bone reconstruction in 47 pediatric candidates to surgical correction of craniosynostosis. Although promising, limited evidence (Level IV) exist that BB and ZTE MRI could help in the surgical planning for craniosynostosis management. The results of two ongoing randomized clinical trials, which are actively enrolling patients, will hopefully help answering this research question.
电离辐射对脑细胞的已知影响一直是在择期和急诊情况下使用非电离成像方法的主要驱动力。小儿神经外科无疑利用了这一临床实践的转变，然而，患有颅面疾病的患者无法充分受益于磁共振成像（MRI）的应用，因为计算机断层扫描（CT）扫描在骨组织成像方面仍具有卓越的能力。
探讨在颅缝早闭评估中使用MRI替代CT扫描的现有知识。
进行一项范围综述，以确定探索基于MRI的骨成像在小儿颅缝早闭患者术前规划中的准确性的标志性研究和正在进行的临床试验。
从PubMed、Ovid Medline、Scopus和Cochrane图书馆数据库中筛选出共492条记录；同时从ClinicalTrials.gov注册库中检索到55条记录。仅纳入围绕使用梯度回波黑骨（BB）和零时间回波（ZTE）MRI序列进行小儿颅缝早闭术前规划的临床研究。
本综述仅确定了五项临床研究，报告了基于MRI的三维骨重建在47例接受颅缝早闭手术矫正的小儿患者中的高准确性。尽管前景乐观，但仅有有限的证据（IV级）表明BB和ZTE MRI有助于颅缝早闭治疗的手术规划。两项正在进行的随机临床试验正在积极招募患者，其结果有望有助于回答这个研究问题。
