Miyagawa Tadashi, Yamaura Akira
Department of Pediatric Neurosurgery, Matsudo City General Hospital.
Neurol Med Chir (Tokyo). 2025 Feb 15;65(2):92-101. doi: 10.2176/jns-nmc.2024-0168. Epub 2024 Dec 10.
To provide appropriate treatment, neurosurgeons and pediatricians must understand the chronological changes of the cranial morphology in normal children and the differences between normal and sagittal synostosis children. However, this issue has remained unresolved due to the traditional methods of analyzing cranial morphology. Therefore, we applied a new and precise method, geometric morphometrics, to understand cranial morphology in children with normal and sagittal synostosis. This study analyzed morphological differences in the cranium of 30 control children and 14 children with sagittal synostosis using geometric morphometrics and the landmark method on the lateral view of the three-dimensional computed tomography of the skull. The results showed that morphological changes in the cranium of normal children with age could be visualized (p < 0.01), with the parietooccipital and suboccipital areas being the main areas of change. Morphological analysis revealed different cranial morphologies among the control, scaphocephalic sagittal synostosis, and non-scaphocephalic sagittal synostosis groups (p < 0.01), as evidenced by a fan-like spread and reduced cranial height in the sagittal synostosis group compared to the control cranium. Visualization in wireframes could reveal morphological differences, even if small, with statistical differences. This study clarified 3 issues regarding the cranial morphology in normal and sagittal children. The study showed evident age-related differences and changes in the cranial morphology in normal children. Differences in cranial morphologies among the 3 groups were identified. Finally, the study demonstrates that geometric morphometrics is a precise and appropriate method for analyzing morphological differences and changes.
为了提供恰当的治疗，神经外科医生和儿科医生必须了解正常儿童颅骨形态的时间变化以及正常儿童与矢状缝早闭儿童之间的差异。然而，由于传统的颅骨形态分析方法，这个问题一直没有得到解决。因此，我们应用了一种新的精确方法——几何形态测量学，来了解正常儿童和矢状缝早闭儿童的颅骨形态。本研究采用几何形态测量学和地标法，对30名对照儿童和14名矢状缝早闭儿童颅骨的三维计算机断层扫描侧位片进行分析，以研究颅骨形态差异。结果显示，正常儿童颅骨形态随年龄的变化可以可视化（p<0.01），顶枕部和枕下部是主要变化区域。形态学分析显示，对照组、舟状头矢状缝早闭组和非舟状头矢状缝早闭组之间存在不同的颅骨形态（p<0.01），矢状缝早闭组与对照颅骨相比，呈现出扇形展开和颅骨高度降低。即使差异很小，线框可视化也能揭示具有统计学差异的形态学差异。本研究阐明了有关正常儿童和矢状缝早闭儿童颅骨形态的3个问题。研究显示正常儿童颅骨形态存在明显的年龄相关差异和变化。确定了3组之间颅骨形态的差异。最后，研究表明几何形态测量学是分析形态差异和变化的一种精确且合适的方法。
