The diagnosis of single-suture craniosynostosis can be made by physical examination, but the use of confirmatory imaging is common practice. The authors sought to investigate preoperative imaging use and to describe intracranial findings in children with single-suture synostosis from a large, prospective multicenter cohort.

In this study from the Synostosis Research Group, the study population included children with clinically diagnosed single-suture synostosis between March 1, 2017, and October 31, 2020, at 5 institutions. The primary analysis correlated the clinical diagnosis and imaging diagnosis; secondary outcomes included intracranial findings by pathological suture type.

A total of 403 children (67% male) were identified with single-suture synostosis. Sagittal (n = 267), metopic (n = 77), coronal (n = 52), and lambdoid (n = 7) synostoses were reported; the most common presentation was abnormal head shape (97%), followed by a palpable or visible ridge (37%). Preoperative cranial imaging was performed in 90% of children; findings on 97% of these imaging studies matched the initial clinical diagnosis. Thirty-one additional fused sutures were identified in 18 children (5%) that differed from the clinical diagnosis. The most commonly used imaging modality by far was CT (n = 360), followed by radiography (n = 9) and MRI (n = 7). Most preoperative imaging was ordered as part of a protocolized pathway (67%); some images were obtained as a result of a nondiagnostic clinical examination (5.2%). Of the 360 patients who had CT imaging, 150 underwent total cranial vault surgery and 210 underwent strip craniectomy. The imaging findings influenced the surgical treatment 0.95% of the time. Among the 24% of children with additional (nonsynostosis) abnormal findings on CT, only 3.5% required further monitoring.

The authors found that a clinical diagnosis of single-suture craniosynostosis and the findings on CT were the same with rare exceptions. CT imaging very rarely altered the surgical treatment of children with single-suture synostosis.

单缝线颅缝早闭的诊断可以通过体格检查做出，但使用确认性影像学是常见的做法。作者试图调查术前影像学的使用，并描述来自大型前瞻性多中心队列的单缝线缝合儿童的颅内发现。

在 Synos​​tosis Research Group 的这项研究中，研究人群包括 2017 年 3 月 1 日至 2020 年 10 月 31 日期间在 5 个机构中临床诊断为单缝线缝合症的儿童。初步分析与临床诊断和影像学诊断相关；次要结果包括病理缝合类型的颅内发现。

共有 403 名儿童（67% 为男性）被鉴定为单线缝合。矢状面 (n = 267)、异位 (n = 77)、冠状面 (n = 52) 和羊角状 (n = 7) 合缝已被报道；最常见的表现是头部形状异常 (97%)，其次是可触及或可见的脊 (37%)。90% 的儿童进行了术前颅脑成像；这些影像学研究中 97% 的结果与最初的临床诊断相符。在与临床诊断不同的 18 名儿童 (5%) 中发现了 31 处额外的融合缝线。迄今为止，最常用的成像方式是 CT（n = 360），其次是 X 线照相（n = 9）和 MRI（n = 7）。大多数术前成像是作为协议途径的一部分订购的（67%）；一些图像是通过非诊断性临床检查获得的 (5.2%)。在进行 CT 成像的 360 名患者中，150 名接受了全颅顶手术，210 名接受了带状颅骨切除术。成像结果影响手术治疗的概率为 0.95%。在 24% 的 CT 上有额外（非缝合）异常发现的儿童中，只有 3.5% 需要进一步监测。

作者发现，单缝线颅缝早闭的临床诊断和 CT 上的发现是相同的，只有少数例外。CT 成像很少改变单缝线缝合儿童的手术治疗。