Аннтотация

© 2019, Pediatria Ltd. All rights reserved. Skull computed tomography (CT), recognized as the «gold standard» in the diagnosis of craniosynostosis (CS), has a significant drawback associated with radiation exposure. The use of ultrasound in the imaging of cranial sutures is a possible research method, replacing CT. Objective of the research: To assess efficacy in CS diagnosis and postoperative observation of children after endoscopic cranioplasty. Materials and methods: The study includes analysis of ultrasound data of cranial sutures in 45 children aged 4,5±1,2 months (from 1,5 to 12 months), which were examined and treated at the Federal Center of Neurosurgery. Ultrasound of cranial sutures was performed on an expert class device. To assess cranial sutures condition authors developed a simple algorithm and an ultrasound protocol, according to which the study was performed. Additionally, all children underwent CT with skull volumetric reconstruction. Results and discussion: According to cranial sutures ultrasound, 14 children had positional plagiocephaly, 12 - metopic craniosynostosis, 18 - sagittal CS and one child had combined CS - a combination of metopic and right part of coronary sutures lesions. Thus, diagnostic imaging allowed to confirm metopic, sagittal and coronary sutures CS. Ultrasound was also performed in the postoperative period in the bone defect area to assess its and other cranial sutures fusion dynamics. The use of the algorithm and ultrasound protocol, in authors opinion greatly facilitates preoperative surgical planning and dynamic observation in the postoperative period. Conclusion: Cranial sutures ultrasound can be considered as an alternative method of instrumental CS diagnosis and patient postoperative management after endoscopic surgery. Described CS ultrasonic classification allows to use it for screening in the early stages of the disease.