Valeggia Silvia, Dremmen Marjolein H G, Mathijssen Irene M J, Gaillard Linda, Manara Renzo, Ceccato Riccardo, van Hattem Martijn, Gahrmann Renske
Neuroradiology, Department of Neurosciences, University of Padova, Via Belzoni, 160, 35121, Padova, Italy.
DIMED, University of Padova, Padova, Italy.
Neuroradiology. 2025 Jan;67(1):257-267. doi: 10.1007/s00234-024-03525-6. Epub 2024 Dec 20.
Craniosynostoses are rare congenital craniofacial malformations, variably affected by hearing loss, often requiring repeated CT examinations to assess skull or temporal bone (TB) abnormalities. In order to avoid radiation exposure in these young patients, efforts are made to assess the skull abnormalities on MR bone imaging sequences, such as Black Bone (BB). Our aim is to compare BB, a radiation-free imaging technique, with CT for the assessment of the TB.
48 patients who underwent both BB and CT (2016-2021) in Sophia Children's Hospital, Erasmus MC, Rotterdam, were retrospectively investigated. BB and CT (the diagnostic gold standard for imaging the temporal bone) were evaluated blindly and independently by 3 observers; visibility and abnormalities of TB structures and cranial nerves were scored; abnormal findings were confirmed by a senior pediatric neuroradiologist. The statistical analysis was performed using Gwet's AC1 agreement and modified versions of the Wilcoxon signed-rank test and sign test with a Bonferroni-Holm correction (p < 0.05).
CT was rated higher than BB in structure visibility (global p = 0.0002), but was rated similar to BB when assessing TB anatomy and pathology (global p = 0.58). The visibility ratings showed better interobserver agreement values on CT than BB. In the normal/abnormal ratings, both BB (0.75-1) and CT (0.88-1) showed high interobserver agreement values.
Our preliminary results suggest that BB is a promising tool for screening TB pathology in patients with craniosynostosis who require MR imaging.
颅缝早闭是一种罕见的先天性颅面畸形，听力损失对其影响各异，常需反复进行CT检查以评估颅骨或颞骨（TB）异常。为避免这些年轻患者受到辐射暴露，人们致力于在MR骨成像序列（如黑骨成像（BB））上评估颅骨异常。我们的目的是比较BB（一种无辐射成像技术）与CT在评估颞骨方面的差异。
对2016年至2021年在鹿特丹伊拉斯姆斯医学中心索菲亚儿童医院同时接受BB和CT检查的48例患者进行回顾性研究。3名观察者对BB和CT（颞骨成像的诊断金标准）进行独立盲法评估；对颞骨结构和颅神经的可视性及异常情况进行评分；异常发现由一名资深儿科神经放射科医生确认。采用Gwet's AC1一致性检验以及经Bonferroni-Holm校正的Wilcoxon符号秩检验和符号检验的改良版本进行统计分析（p < 0.05）。
在结构可视性方面，CT的评分高于BB（总体p = 0.0002），但在评估颞骨解剖结构和病理情况时，CT的评分与BB相似（总体p = 0.58）。可视性评分显示，CT的观察者间一致性值优于BB。在正常/异常评分中，BB（0.75 - 1）和CT（0.88 - 1）均显示出较高的观察者间一致性值。
我们的初步结果表明，对于需要进行MR成像的颅缝早闭患者，BB是一种有前景的颞骨病理筛查工具。
