RESUMO
The gold standard for measuring cranial vault volume is a computed tomography (CT) scan. Computed tomography scans in the pediatric population carry the significant risk of inducing a malignancy later in life. In a novel study, we show that a three-dimensional (3D) photograph can be used to measure and track cranial vault volume changes in craniosynostosis patients. In a study of adequate power as determined by pre hoc analysis, we demonstrate a greater than 0.91 correlation coefficient between volume as measured by CT and 3D photograph in more than 70 patients presenting to a tertiary craniofacial center (P < 0.001). Volume above a plane running through the lateral canthus (ex) and tragus (t) sag-ex-t on the digital 3D photograph differs from CT by a mean percentage difference of 31.9% (SD, 14.0%; 95% confidence interval, P < 0.0001). A linear regression model was used to determine the equation describing the relationship between volume as measured by 3D photograph and CT; with this equation, the absolute volume of the cranial vault is easily determined using only the 3D image. Interrater reliability is high (>0.99, ICC). The ability to measure cranial vault volume from the 3D photograph adds an important dimension to the complete and objective analysis of skull growth and postoperative change.
Assuntos
Craniossinostoses/patologia , Imageamento Tridimensional , Fotografação/métodos , Crânio/patologia , Criança , Pré-Escolar , Craniossinostoses/diagnóstico por imagem , Feminino , Humanos , Lactente , Modelos Lineares , Masculino , Estudos Prospectivos , Crânio/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The Melbourne method of total vault remodeling was developed at The Royal Children's Hospital (Melbourne) to address all phenotypic aspects of scaphocephaly. To quantitatively evaluate this technique, a retrospective analysis was performed on 33 consecutive patients who underwent the Melbourne procedure between October 2004 and June 2007. To monitor outcomes, three-dimensional digital surface photography was used, obtaining 4 anthropometric measurements (cranial length, cranial width, head circumference, auricular head height) preoperatively and postoperatively. To assess the effect on continuing cranial vault development, cranial volume was calculated with computed tomography. Anthropometric measurements were obtained in 27 patients (81.8%), with a mean postoperative follow-up of 8.9 months. Cranial index (width/length) demonstrated an 11.1% improvement. The mean head circumference in the scaphocephaly group preoperatively remained larger than the normative population postoperatively, although the magnitude of difference was decreased, whereas the mean auricular head height demonstrated a 10.5% increase postoperatively, remaining higher than the normative population. Cranial volume was calculated in 30 patients (91%), with a mean postoperative follow-up of 7.9 months. This demonstrated that the mean intracranial volume was significantly higher in the scaphocephaly group preoperatively, and this difference was maintained postoperatively. These results support our belief that the Melbourne procedure is a technique that may be used to correct all phenotypic aspects of scaphocephaly, with no apparent evidence for a detrimental effect on cranial growth.
Assuntos
Procedimentos de Cirurgia Plástica/métodos , Crânio/anormalidades , Crânio/cirurgia , Antropometria , Pré-Escolar , Feminino , Humanos , Imageamento Tridimensional , Lactente , Masculino , Fenótipo , Fotografação , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
In 2004, traditional clinical photography services at the Educational Resource Centre were extended using new technology. This paper describes the establishment of a 3D digital imaging system in a paediatric setting at the Royal Children's Hospital, Melbourne.
Assuntos
Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Ilustração Médica , Pediatria/métodos , Fotografação , Criança , Hospitais Pediátricos , HumanosRESUMO
Sistemas digitais sofisticados de fotografia em três dimensões melhoraram muito a captura de imagens do corpo humano. A introdução de um sistema rápido, não-invasivo e sem radiação ionizante, e esses avanços possibilitam novas aplicações da imagem em três dimensões na cirurgia plástica. Desde 2004, o Royal Children's Hospital (RCH) de Melbourne utiliza o sistema de fotografia digital em três dimensões 3dMD, que foi montado num centro exclusivamente dedicado (Centro de imagens da Batten Foundation). Desde então, uma equipe multidisciplinar trabalha para desenvolver técnicas mais apuradas para coletar e analisar informações para que se possa titrar pleno proveito dessa poderosa tecnologia. Este artigo descreve uma série de aplicações clínicas onde a captura de dados em três dimensões e sua análise têm sido úteis.