Diagnostic ultrasound ( PDFDrive )

1138 PART IV Obstetric and Fetal Sonography
A
B
C
FIG. 33.5 Craniosynostosis With Cloverleaf Skull Deformity.
(A) Coronal sonogram shows cloverleaf skull deformity at
37 weeks’ gestation secondary to combined coronal, lambdoidal,
and squamous (squamosal) suture synostosis. (B) and (C) Sagittal
and axial magnetic resonance images show turribrachycephaly
(multiple suture closures allow only growth superiorly; “tower head”).
premature closure of cranial sutures (Fig. 33.5). About 85% of
cases are isolated and about 15% syndromic. Craniosynostosis
is associated with multiple syndromes, including Apert, Crouzon,
Pfeifer, Antley-Bixler, Beare-Stevenson, Fetter, and Carpenter,
as well as thanatophoric dysplasia. he abnormal head shapes
resulting from craniosynostosis can lead to facial abnormalities,
including hypertelorism, hypotelorism, exorbitism, and midface
hypoplasia. Dolichocephaly (oblong head) is the most common
craniosynostosis condition and results from premature fusion
of the sagittal suture. Asymmetrical heads are termed
plagiocephalic. 24
When fetal position is favorable, it is possible to trace the
sutures sonographically and to evaluate their patency using
high-frequency linear array probes.
Classiication of Skull Deformities Based on
Sutures Involved
Dolichocephaly/scaphocephaly: sagittal suture; most
common synostosis
Anterior plagiocephaly: one coronal suture
Posterior plagiocephaly: one lambdoid suture
Brachycephaly: bilateral coronal suture; second most
common synostosis
Trigonocephaly: metopic suture
Oxycephaly/turricephaly: all skull sutures and sutures at
base of skull
Cloverleaf (kleeblattschädel): all but squamous (squamosal)
suture