Imaging of craniosynostosis

Craniosynostosis-the early closure of one or more cranial sutures-alters skull growth patterns and may contribute to elevated intracranial pressure or neurodevelopmental issues. Although the diagnosis often begins with physical examination, imaging is essential for confirming suture involvement, identifying secondary deformities, and guiding operative planning. ۳D-reconstructed MDCT performed under minimized radiation protocols remains the reference standard for detailed cranial vault assessment, offering unparalleled visualization of fused sutures and calvarial morphology. In younger infants, cranial ultrasound through an open fontanelle can provide a rapid, radiation-free first assessment. MRI, while less effective for bony anatomy, is valuable in evaluating associated intracranial malformations, venous drainage, and syndromic presentations. Innovations such as ultra-low-dose CT protocols, black-bone MRI, and artificial intelligence-driven image analysis are reshaping diagnostic strategies, aiming to reduce radiation risk while enhancing accuracy.