Abstract：
OBJECTIVE: Calvarial dermoid and epidermoid cysts are benign lesions common in pediatric neurosurgery. Diagnosis is primarily clinical, with frequent but inconsistent use of imaging. Dermoids have been shown to possess distinct sonographic features, but ultrasound (US) remains underutilized in their management. The purpose of this study is to investigate the independent reliability of US in managing pediatric calvarial dermoids and distinguishing them from other calvarial lesions.
METHODS: A retrospective review of consecutive patients ≤ 21 years of age with surgically resected calvarial masses between 2017-2024 was performed. Demographic, clinical, and imaging data were analyzed. Pearson chi-squared tests were used for comparison of categorical variables and a binomial linear model was generated controlling for age, lesion tenderness, growth, and suture location.
RESULTS: Fifty-nine patients with 61 lesions (31 in females; median age 13 months) were included. Dermoids were more common in younger patients (median age 12 months), along suture lines, and were less likely to present with tenderness (p < 0.001) or rapid growth (p = 0.003). Ultrasound was used in 83% of cases and was the sole imaging modality in 33%. On multivariate analysis, suture location was a significant positive predictor of a dermoid diagnosis (OR = 8.08, 95% CI = 1.67-44.18), while rapid growth was a significant negative predictor (OR = 0.08, 95% CI = 0.003-0.80).
CONCLUSIONS: Ultrasound presents a sensitive and reliable method for the evaluation of most pediatric calvarial lesions, especially dermoid cysts, and warrants being part of standard workup. With appropriate patient selection, US obviates the need for additional imaging in pediatric patients.
METHODS: A retrospective review of consecutive patients ≤ 21 years of age with surgically resected calvarial masses between 2017-2024 was performed. Demographic, clinical, and imaging data were analyzed. Pearson chi-squared tests were used for comparison of categorical variables and a binomial linear model was generated controlling for age, lesion tenderness, growth, and suture location.
RESULTS: Fifty-nine patients with 61 lesions (31 in females; median age 13 months) were included. Dermoids were more common in younger patients (median age 12 months), along suture lines, and were less likely to present with tenderness (p < 0.001) or rapid growth (p = 0.003). Ultrasound was used in 83% of cases and was the sole imaging modality in 33%. On multivariate analysis, suture location was a significant positive predictor of a dermoid diagnosis (OR = 8.08, 95% CI = 1.67-44.18), while rapid growth was a significant negative predictor (OR = 0.08, 95% CI = 0.003-0.80).
CONCLUSIONS: Ultrasound presents a sensitive and reliable method for the evaluation of most pediatric calvarial lesions, especially dermoid cysts, and warrants being part of standard workup. With appropriate patient selection, US obviates the need for additional imaging in pediatric patients.
摘要：
目的：颅骨皮样和表皮样囊肿是小儿神经外科常见的良性病变。诊断主要是临床，成像使用频繁但不一致。皮样病变已被证明具有独特的超声特征，但超声波（美国）在他们的管理中仍未得到充分利用。这项研究的目的是调查US在处理小儿颅骨皮样病变并将其与其他颅骨病变区分开方面的独立可靠性。
方法：对2017-2024年间手术切除颅骨肿块的年龄≤21岁的连续患者进行回顾性回顾。人口统计,临床,并对影像学资料进行分析。Pearson卡方检验用于比较分类变量，并生成控制年龄的二项线性模型，病变压痛，增长,和缝合位置。
结果：纳入59例患者，61个病灶（女性31例，中位年龄13个月）。皮样病变在年轻患者中更为常见（中位年龄12个月），沿着缝合线,并且不太可能出现压痛（p<0.001）或快速生长（p=0.003）。83％的病例使用超声，而33％的病例是唯一的成像方式。在多变量分析中，缝合位置是皮样诊断的显著阳性预测因子(OR=8.08,95%CI=1.67-44.18),而快速增长是一个显著的负预测因子(OR=0.08，95%CI=0.003-0.80)。
结论：超声为评估大多数小儿颅骨病变提供了一种灵敏可靠的方法，尤其是皮样囊肿,和认股权证是标准工作的一部分。通过适当的患者选择，US消除了对儿科患者进行额外成像的需要。
方法：对2017-2024年间手术切除颅骨肿块的年龄≤21岁的连续患者进行回顾性回顾。人口统计,临床,并对影像学资料进行分析。Pearson卡方检验用于比较分类变量，并生成控制年龄的二项线性模型，病变压痛，增长,和缝合位置。
结果：纳入59例患者，61个病灶（女性31例，中位年龄13个月）。皮样病变在年轻患者中更为常见（中位年龄12个月），沿着缝合线,并且不太可能出现压痛（p<0.001）或快速生长（p=0.003）。83％的病例使用超声，而33％的病例是唯一的成像方式。在多变量分析中，缝合位置是皮样诊断的显著阳性预测因子(OR=8.08,95%CI=1.67-44.18),而快速增长是一个显著的负预测因子(OR=0.08，95%CI=0.003-0.80)。
结论：超声为评估大多数小儿颅骨病变提供了一种灵敏可靠的方法，尤其是皮样囊肿,和认股权证是标准工作的一部分。通过适当的患者选择，US消除了对儿科患者进行额外成像的需要。
