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Abstract

Craniosynostosis: diagnostic imaging with three-dimensional CT presentation.

M W Vannier, T K Pilgram, J L Marsh, B B Kraemer, S C Rayne, M H Gado, C J Moran, W H McAlister, G D Shackelford and R A Hardesty
American Journal of Neuroradiology November 1994, 15 (10) 1861-1869;
M W Vannier
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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T K Pilgram
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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J L Marsh
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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B B Kraemer
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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S C Rayne
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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M H Gado
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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C J Moran
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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W H McAlister
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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G D Shackelford
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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R A Hardesty
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
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Abstract

PURPOSE To measure diagnostic performance and preference of two three-dimensional CT reconstruction modalities (voxel-gradient and surface-projection) displayed two ways (conventional and unwrapped) in craniosynostosis confirmed by surgical inspection and histologic analysis of resected sutures.

METHODS High-resolution 2-mm contiguous CT sections were obtained and three-dimensional reconstruction images generated for 25 infants and children with skull deformities before surgical treatment of craniosynostosis. Two pediatric radiologists and two neuroradiologists first ranked images by their own preferences for diagnostic use. Then they diagnosed craniosynostosis from images presented in random order and blinded. The standard of reference was inspection during surgery and histologic evaluation of excised sutures. Finally, reviewers repeated their subjective preference tests.

RESULTS The least experienced radiologist had 100% sensitivity for all imaging modalities and specificities ranging from 43% to 83%. The two most experienced radiologists performed nearly identically, with sensitivities of 96% and specificities of 100%. After performing diagnostic tasks using all image types, all radiologists preferred conventional surface projections.

CONCLUSION Experienced readers can achieve nearly perfect diagnostic performance using the latest three-dimensional CT reconstruction images, making it a contribution to the diagnostic process. Although performance is nearly identical for all modalities, readers strongly prefer conventionally presented surface-projection images.

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American Journal of Neuroradiology
Vol. 15, Issue 10
1 Nov 1994
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Craniosynostosis: diagnostic imaging with three-dimensional CT presentation.
M W Vannier, T K Pilgram, J L Marsh, B B Kraemer, S C Rayne, M H Gado, C J Moran, W H McAlister, G D Shackelford, R A Hardesty
American Journal of Neuroradiology Nov 1994, 15 (10) 1861-1869;

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Craniosynostosis: diagnostic imaging with three-dimensional CT presentation.
M W Vannier, T K Pilgram, J L Marsh, B B Kraemer, S C Rayne, M H Gado, C J Moran, W H McAlister, G D Shackelford, R A Hardesty
American Journal of Neuroradiology Nov 1994, 15 (10) 1861-1869;
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