How ultrasonography can contribute to diagnosis of craniosynostosis

Introduction: The aim of this article was to provide an overview of ultrasound (US) techniques for the investigation of cranial sutures in infants.

Material and methods: We first describe a high-resolution sonography technique and its limitations. We then analyze the reliability, effectiveness and role of ultrasonography in routine practice using a PubMed literature review.

Results: Ten studies reported excellent correlations between ultrasonography and 3D-CT. Cranial US for the diagnosis of a closed suture had 100% sensitivity in 8 studies and 86-100% specificity before the age of 12 months. Negative findings mean imaging investigation can be stopped. If ultrasonography confirms diagnosis, neurosurgical consultation is required. Thus, 3D-CT can be postponed until appropriate before surgery.

Conclusion: Cranial suture ultrasound is an effective and reliable technique for the diagnosis of craniosynostosis. It has many advantages: it is fast and non-irradiating, and no sedation is required. It should be used as first-line imaging in infants below the age of 8-12 months when craniosynostosis is clinically suspected.