Introducing a new method for classifying skull shape abnormalities related to craniosynostosis
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ORIGINAL ARTICLE
Introducing a new method for classifying skull shape abnormalities related to craniosynostosis Otto D. M. Kronig 1 & Sophia A. J. Kronig 1,2 & Henri A. Vrooman 3,4 & Jifke F. Veenland 3,4 & Mariëlle Jippes 1 & Terence Boen 1 & Léon N. A. Van Adrichem 2 Received: 6 October 2019 / Revised: 10 March 2020 / Accepted: 20 March 2020 # The Author(s) 2020
Abstract We present a novel technique for classification of skull deformities due to most common craniosynostosis. We included 5 children of every group of the common craniosynostoses (scaphocephaly, brachycephaly, trigonocephaly, and right- and leftsided anterior plagiocephaly) and additionally 5 controls. Our outline-based classification method is described, using the software programs OsiriX, MeVisLab, and Matlab. These programs were used to identify chosen landmarks (porion and exocanthion), create a base plane and a plane at 4 cm, segment outlines, and plot resulting graphs. We measured repeatability and reproducibility, and mean curves of groups were analyzed. All raters achieved excellent intraclass correlation scores (0.994–1.000) and interclass correlation scores (0.989–1.000) for identifying the external landmarks. Controls, scaphocephaly, trigonocephaly, and brachycephaly all have the peak of the forehead in the middle of the curve (180°). In contrary, in anterior plagiocephaly, the peak is shifted (to the left of graph in right-sided and vice versa). Additionally, controls, scaphocephaly, and trigonocephaly have a high peak of the forehead; scaphocephaly has the lowest troughs; in brachycephaly, the width/frontal peak ratio has the highest value with a low frontal peak. Conclusion: We introduced a preliminary study showing an objective and reproducible methodology using CT scans for the analysis of craniosynostosis and potential application of our method to 3D photogrammetry. What is Known: • Diagnosis of craniosynostosis is relatively simple; however, classification of craniosynostosis is difficult and current techniques are not widely applicable.
Otto Kronig and Sophia Kronig have shared first authorship. Communicated by Piet Leroy * Sophia A. J. Kronig [email protected]
Léon N. A. Van Adrichem [email protected] 1
Department of Plastic and Reconstructive Surgery and Hand Surgery, Dutch Craniofacial Centre, Erasmus MC - Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
2
Department of Plastic and Reconstructive Surgery and Hand Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
Mariëlle Jippes [email protected]
3
Department of Radiology, Erasmus MC, Rotterdam, University Medical Centre Rotterdam, Rotterdam, The Netherlands
Terence Boen [email protected]
4
Department of Medical Informatics, Erasmus MC, Rotterdam, University Medical Centre Rotterdam, Rotterdam, The Netherlands
Otto D. M. Kronig [email protected] Henri A. Vrooman [email protected] Jifke F. Veenland [email protected]
Eur J Pediatr What is New: • We
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