Objective

The current study evaluates the feasibility of using clinical cranial computed tomography (CT) scans for assessing the presence and morphology of porous cranial lesions (cribra orbitalia, porotic hyperostosis).

Methods

Observers (n = 4) conducted three independent evaluations of porous cranial lesions based on photographs, 2-D CT, and 3-D CT scans of archaeological crania. Evaluations of the crania from each viewing scenario were compared to findings from direct macroscopic observation.

Materials

Twenty-two complete adult crania from the Peruvian sites of Pachacamac and Chicama.

Results

We found that lesion visibility differed by location: vault lesions with porosity larger than the resolution of the CT scan were identifiable across all viewing scenarios, but orbital lesions were identifiable only when extensive porosity was accompanied by widening of the inter-trabecular spaces. Lesions in stages of advanced remodeling were not visible on CT.

Conclusions

Paleopathological criteria applied to head CTs from clinical cases of suspected cranial fracture can reliably identify moderate to severe porous cranial lesions in living individuals.

Significance

This validation study opens the door to broader study of porous cranial lesions in living individuals that can address open questions about the causes and consequences of these commonly reported skeletal indicators of stress.

Limitations

Performance of all viewing scenarios was evaluated relative to assessment data from direct observation of skeletal remains, but direct observation is itself subject to error.

Suggestions for Further Research

The increasing resolution of routine CTs makes it increasingly possible to explore skeletal lesions in clinical contexts.

中文翻译：

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计算机断层扫描结果与传统的骨学检查一致吗？多孔性颅骨病变案例

客观的

目前的研究评估了使用临床颅脑计算机断层扫描 (CT) 扫描来评估多孔颅骨病变（眼眶、多孔性骨质增生）的存在和形态的可行性。

方法

观察者 (n = 4) 根据考古颅骨的照片、2-D CT 和 3-D CT 扫描对多孔颅骨病变进行了三项独立评估。将每个观察场景对颅骨的评估与直接宏观观察的结果进行比较。

材料

来自秘鲁帕查卡马克和奇卡马遗址的 22 个完整的成人颅骨。

结果

我们发现病变的可见性因位置而异：在所有观察场景中都可以识别孔隙度大于 CT 扫描分辨率的穹窿病变，但只有当大量孔隙伴随小梁间隙增宽时，才能识别眼眶病变。晚期重塑阶段的病变在 CT 上不可见。

结论

应用于疑似颅骨骨折临床病例的头部 CT 的古病理学标准可以可靠地识别活人的中度至重度多孔颅骨病变。

意义

这项验证研究为更广泛地研究活人的多孔颅骨病变打开了大门，可以解决有关这些常见压力骨骼指标的原因和后果的开放性问题。

限制

相对于直接观察骨骼遗骸的评估数据，对所有观看场景的性能进行了评估，但直接观察本身容易出错。

进一步研究的建议

常规 CT 分辨率的提高使得在临床环境中探索骨骼病变的可能性越来越大。