Karen Ann Eley MBBCh, DPhil, Presenter: Nothing to Disclose

Fintan Sheerin MBBCh, Abstract Co-Author: Nothing to Disclose

Stephen Richard Watt-Smith MD, MBBS, Abstract Co-Author: Nothing to Disclose

Stephen John Golding MD, Abstract Co-Author: Nothing to Disclose

“Black Bone” MRI is a novel gradient echo sequence providing improved definition of the bone-soft tissue margin by minimising soft tissue contrast. We sought to determine the potential of “Black Bone” MRI as a non-ionising alternative to CT in the identification of cranial sutures and diagnosis of craniosynostosis.  

A prospective study of 4 children with normal cranial sutures and 13 children with a clinical diagnosis of craniosynostosis was conducted following initial investigation of the “Black Bone” sequence in an animal model. Normal cranial sutures were assessed by measurement of suture widths with reference to normative data. “Black Bone” datasets in the 13 children with craniosynostosis were compared to CT and clinical findings. Blinded review of 12 “Black Bone” datasets from children was completed by 3 assessors, grading each cranial suture on a scale of 0 to 2. To provide comparable imaging to CT and enhance visualisation of the cranial sutures, techniques were developed to produce three-dimensional rendered images of the craniofacial skeleton. 

Patent cranial sutures were consistently identified on the “Black Bone” datasets as areas of increased signal distinguished from the signal void of the cranial bone. In children with craniosynostosis the affected suture was absent, whilst the remaining patent sutures could be visualised. These findings were consistent with those on CT. On independent review, synostosed sutures received the lowest mean scores. Three-dimensional rendered images permitted visualisation of the cranial sutures throughout their course. 

Patent cranial sutures appear as areas of increased signal on “Black Bone” MRI clearly distinguished from the cranial bone. The sequence accurately differentiates the normal suture from the prematurely fused, demonstrating considerable clinical potential as a non-ionising alternative to CT in the diagnosis of craniosynostosis.

“Black Bone” MRI offers a non-ionising alternative to CT in the investigation of craniosynostosis, with the ability to produce three-dimensionally rendered images to enhance diagnostic capabilities. 

Eley, K, Sheerin, F, Watt-Smith, S, Golding, S, A Novel MRI Sequence (“Black Bone”) Offering an Alternative to Ionising Radiation in the Investigation of Craniosynostosis.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13013577.html