Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Department of Pediatric Plastic & Reconstructive Surgery, Children's Hospital Colorado, Aurora, CO, USA.
Neuroradiology. 2024 Oct;66(10):1817-1828. doi: 10.1007/s00234-024-03393-0. Epub 2024 Jun 14.
The diagnosis of chronic increased intracranial pressure (IIP)is often based on subjective evaluation or clinical metrics with low predictive value. We aimed to quantify cranial bone changes associated with pediatric IIP using CT images and to identify patients at risk.
We retrospectively quantified local cranial bone thickness and mineral density from the CT images of children with chronic IIP and compared their statistical differences to normative children without IIP adjusting for age, sex and image resolution. Subsequently, we developed a classifier to identify IIP based on these measurements. Finally, we demonstrated our methods to explore signs of IIP in patients with non-syndromic sagittal craniosynostosis (NSSC).
We quantified a significant decrease of bone density in 48 patients with IIP compared to 1,018 normative subjects (P < .001), but no differences in bone thickness (P = .56 and P = .89 for age groups 0-2 and 2-10 years, respectively). Our classifier demonstrated 83.33% (95% CI: 69.24%, 92.03%) sensitivity and 87.13% (95% CI: 84.88%, 89.10%) specificity in identifying patients with IIP. Compared to normative subjects, 242 patients with NSSC presented significantly lower cranial bone density (P < .001), but no differences were found compared to patients with IIP (P = .57). Of patients with NSSC, 36.78% (95% CI: 30.76%, 43.22%) presented signs of IIP.
Cranial bone changes associated with pediatric IIP can be quantified from CT images to support earlier diagnoses of IIP, and to study the presence of IIP secondary to cranial pathology such as non-syndromic sagittal craniosynostosis.
慢性颅内压增高（IIP）的诊断通常基于主观评估或临床指标，这些指标的预测价值较低。我们旨在使用 CT 图像量化与儿童 IIP 相关的颅骨变化，并确定风险患者。
我们回顾性地从患有慢性 IIP 的儿童的 CT 图像中量化了局部颅骨厚度和矿物质密度，并在调整年龄、性别和图像分辨率后，比较了它们与没有 IIP 的正常儿童的统计差异。随后，我们开发了一种分类器，基于这些测量值来识别 IIP。最后，我们展示了我们的方法来探索非综合征性矢状缝早闭（NSSC）患者的 IIP 迹象。
与 1018 名正常受试者相比，我们在 48 名患有 IIP 的患者中量化了骨密度的显著降低（P<0.001），但在骨厚度方面没有差异（年龄组 0-2 岁和 2-10 岁的 P 值分别为 P=0.56 和 P=0.89）。我们的分类器在识别 IIP 患者时表现出 83.33%（95%CI：69.24%，92.03%）的敏感性和 87.13%（95%CI：84.88%，89.10%）的特异性。与正常受试者相比，242 名 NSSC 患者的颅骨密度明显较低（P<0.001），但与 IIP 患者相比无差异（P=0.57）。在 NSSC 患者中，36.78%（95%CI：30.76%，43.22%）出现 IIP 迹象。
可以从 CT 图像中量化与儿童 IIP 相关的颅骨变化，以支持 IIP 的早期诊断，并研究继发于颅骨病变（如非综合征性矢状缝早闭）的 IIP 的存在。
