Three-dimensional skull models as a problem-solving tool in suspected child abuse.

Background: The value of 3-D skull models in evaluation of young children with suspected child abuse is not known.Objective: The purpose of this study was to assess the value of 3-D skull models as a problem-solving tool in children younger than 2 years.Materials and Methods: We performed a retrospe...

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Published in:Pediatric Radiology Vol. 43; no. 3; pp. 575 - 582
Main Authors: Prabhu, Sanjay P, Newton, Alice W, Perez-Rossello, Jeannette M, Kleinman, Paul K
Format: research Journal Article
Published: Springer Nature Mar2013
Online Access:View this record in EBSCOhost
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      dt: Mar2013
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00247-012-2546-4
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        atl: Three-dimensional skull models as a problem-solving tool in suspected child abuse.
      aug:
        au:
          Prabhu, Sanjay P
          Newton, Alice W
          Perez-Rossello, Jeannette M
          Kleinman, Paul K
        affil: Department of Radiology, Harvard Medical School, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA, sanjay.prabhu@childrens.harvard.edu.
      sug:
        subj:
          Child Abuse Diagnosis
          Imaging, Three-Dimensional Methods
          Models, Anatomic
          Problem Solving
          Radiographic Image Interpretation, Computer-Assisted Methods
          Skull Fractures Ultrasonography
          Child Abuse Prevention and Control
          Computer Simulation
          Diagnosis, Differential
          Female
          Human
          Infant
          Infant, Newborn
          Male
          Reproducibility of Results
          Sensitivity and Specificity
          Infant: 1-23 months
          Infant, Newborn: birth-1 month
          Female
          Male
      ab: Background: The value of 3-D skull models in evaluation of young children with suspected child abuse is not known.Objective: The purpose of this study was to assess the value of 3-D skull models as a problem-solving tool in children younger than 2 years.Materials and Methods: We performed a retrospective study on 73 children (ages 0-24 months) seen by a child protection team (CPT) who were undergoing head CT between August 2007 and July 2009.Results: Of the 73 children, volume-rendered 3-D models were obtained in 26 (35.6%). Three-dimensional models changed initial CT interpretation in nine instances (34.6%). Findings thought to be fractures were confirmed as normal variants in four children. Depressed fractures were correctly shown to be ping-pong fractures in two cases. In one case, an uncertain finding was confirmed as a fracture, and an additional contralateral fracture was identified in one child. A fracture seen on skull radiographs but not seen on axial CT images was identified on the 3-D model in one case. Changes in interpretation led to modification in management in five children.Conclusion: Use of 3-D skull models can be a problem-solving tool when there is discordance among the CT reading, subsequent radiographic investigations and clinical evaluation.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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