Cranial bone thickness and density anomalies quantified from CT images can identify chronic increased intracranial pressure

Authors

Jiawei Liu, Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. jiawei.liu@cuanschutz.edu.
Jasmine Chaij, Department of Pediatric Plastic & Reconstructive Surgery, Children's Hospital Colorado, Aurora, CO, USA.
Marius George Linguraru, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA.
Brooke French, Department of Pediatric Plastic & Reconstructive Surgery, Children's Hospital Colorado, Aurora, CO, USA.
Robert Keating, Department of Neurosurgery, Children's National Hospital, Washington, DC, USA.
Allyson L. Alexander, Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, USA.
Antonio R. Porras, Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. antonio.porras@cuanschutz.edu.

Document Type

Journal Article

Publication Date

6-14-2024

Journal

Neuroradiology

DOI

10.1007/s00234-024-03393-0

Keywords

Cranial bone anomalies; Head CT image; Pediatric chronic increased intracranial pressure

Abstract

PURPOSE: The diagnosis of chronic increased intracranial pressure (IIP)is often based on subjective evaluation or clinical metrics with low predictive value. We aimed to quantify cranial bone changes associated with pediatric IIP using CT images and to identify patients at risk. METHODS: We retrospectively quantified local cranial bone thickness and mineral density from the CT images of children with chronic IIP and compared their statistical differences to normative children without IIP adjusting for age, sex and image resolution. Subsequently, we developed a classifier to identify IIP based on these measurements. Finally, we demonstrated our methods to explore signs of IIP in patients with non-syndromic sagittal craniosynostosis (NSSC). RESULTS: We quantified a significant decrease of bone density in 48 patients with IIP compared to 1,018 normative subjects (P < .001), but no differences in bone thickness (P = .56 and P = .89 for age groups 0-2 and 2-10 years, respectively). Our classifier demonstrated 83.33% (95% CI: 69.24%, 92.03%) sensitivity and 87.13% (95% CI: 84.88%, 89.10%) specificity in identifying patients with IIP. Compared to normative subjects, 242 patients with NSSC presented significantly lower cranial bone density (P < .001), but no differences were found compared to patients with IIP (P = .57). Of patients with NSSC, 36.78% (95% CI: 30.76%, 43.22%) presented signs of IIP. CONCLUSION: Cranial bone changes associated with pediatric IIP can be quantified from CT images to support earlier diagnoses of IIP, and to study the presence of IIP secondary to cranial pathology such as non-syndromic sagittal craniosynostosis.

APA Citation

Liu, Jiawei; Chaij, Jasmine; Linguraru, Marius George; French, Brooke; Keating, Robert; Alexander, Allyson L.; and Porras, Antonio R., "Cranial bone thickness and density anomalies quantified from CT images can identify chronic increased intracranial pressure" (2024). GW Authored Works. Paper 5101.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5101

Department

Radiology