Calvarial Deformities in Children: A Radiological Gamut, Studied at a Tertiary Hospital

Abstract

Aims and Objectives: To present the application of a protocol of low dose optimized for multidetector TC of 64 slice developed in our institution and directed to the study of the cranial deformity in the pediatric population. • Compare the radiation doses obtained with this protocol with the standard reference levels recommended by ICRP (International council for Radiation Protection). • To evaluate the diagnostic quality of the images obtained with this protocol. Materials and Methods: We present this prospective study conducted in our institution between August 2015 and September 2017. A total of 87 studies were conducted in 81 patients (61 boys and 20 girls) with an age range of between 4 days and 6.5 years (median of 7 months). A single study was performed in 76 patients, two studies in 4 patients and three studies in 1 patient. All studies were carried out with a 64 slice MDCT (Multidetector CT) scanner with bone reconstruction (Philips Brilliance USA), equipped with an automatic dose modulation system on the Z axis (AutomA) and subsequent images in MIP (maximum intensity projection), MPR (Multiplanar Reconstruction) and 3D mode. Results: Of the total of 87 studies, 69 were initial CT for diagnosis, while 18 were follow-up studies. Of these 18 controls, 12 patients had one or more previous CT studies performed with our standard protocol. The studies were required, in descending order, by neurosurgeons, pediatricians and rehabilitators. The most frequent reason for the request was the study of cranial deformities, especially to differentiate between significant postural plagiocephaly and craniosynostosis; less frequently, they were requested for postsurgical control or for the evolutionary follow-up of fractures. Conclusion: This low dose protocol optimized for TCMD-64 and aimed at the study of cranial lesions, obtains images with good diagnostic quality using very low radiation doses. It may even obviate the need for simple radiography in clinically selected patients.