Three-Dimensional versus Two-Dimensional Evaluations of Cranial Asymmetry in Deformational Plagiocephaly Using a Three-Dimensional Scanner
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Subjects
2.2. Data Acquisition Using the 3D Scanner
2.3. Data Analysis Method
2.3.1. How to Calculate ASR and PSR
2.3.2. Cross-Sectional Level for 2D Measurement
2.3.3. How to Calculate CA
2.4. Severity Classifications
2.5. Study Methods and Statistical Analyses
- (1)
- Age, height, weight, and head circumference at the measurement date were collected.
- (2)
- To determine the repeatability of the 3D scanner, six replicates of the scans were performed by one examiner (intra-examiner precision analysis). Six replicate scans were then performed by six different examiners (one scan per examiner; inter-examiner precision analysis). Mean, standard deviation (SD), and coefficient of variation (CV) were then calculated.
- (1)
- Perinatal and neonatal factors included sex, gestational weeks at birth, birth weight, age at the time of measurement, mode of delivery, and intrauterine position.
- (2)
- The values of head circumferences measured by the 3D scanner and by trained nurses were compared using bivariable normal ellipses, and regression analysis (correlation coefficient [r] was calculated).
- (3)
- Distribution maps of the ASRs, PSRs, and CAs are shown. Each infant was classified by severity (mild or severe) using CA for the 2D evaluation, and ASR alone, PSR alone, or ASR and PSR for the 3D evaluation. The coincidence rate was analyzed, and the indicative variable in the 3D evaluation that showed the maximum coincidence rate was determined.
- (4)
- Finally, infants whose severity assessed differently, especially the group identified as mild on the 2D evaluation and severe on the 3D evaluation, were selected. Using CA on planes other than level 3 at levels 2–8, we investigated whether there was a change in the coincidence rate.
3. Results
3.1. Study 1
3.1.1. Subject
3.1.2. Measurement Precision
3.2. Study 2
3.2.1. Clinical Characteristics
3.2.2. Correlation of Measurement Values
3.2.3. Severity Classifications
3.2.4. CAs of Other Levels
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Intra-Examiner | Inter-Examiner | |||
---|---|---|---|---|
Mean ± SD | CV (%) | Mean ± SD | CV (%) | |
n = 6 | n = 6 | |||
Cranial length, mm | 202.3 ± 0.5 | 0.26 | 203.0 ± 0.8 | 0.39 |
Cranial width, mm | 171.7 ± 0.2 | 0.13 | 171.8 ± 0.3 | 0.16 |
Head circumference, mm | 582.9 ± 1.2 | 0.20 | 582.9 ± 0.7 | 0.12 |
CA, mm | 10.0 ± 0.6 | 5.62 | 10.0 ± 0.5 | 5.33 |
ASR, % | 98.7 ± 0.2 | 0.24 | 98.6 ± 0.2 | 0.15 |
PSR, % | 83.4 ± 0.4 | 0.50 | 83.7 ± 0.3 | 0.38 |
Male, % | 315 (59.4) |
Gestational age at birth, weeks | 39 (37–42) |
Birth weight, grams | 3024 (1639–4144) |
Age at measurement, months | 3 (0–47) |
Mode of delivery | |
Vaginal | 313 (59.0) |
Caesarean | 161 (30.3) |
Vacuum | 45 (8.4) |
Forceps | 11 (2.0) |
Intrauterine position | |
Cephalic | 494 (93.2) |
Breech | 31 (5.8) |
Transverse | 5 (0.9) |
(A) | CA | |||
---|---|---|---|---|
Mild | Severe | Total | ||
ASR ≥ 80.5% | Mild | 383 (72.3%) | 140 (26.4%) | 523 (98.7%) |
ASR < 80.5% | Severe | 1 (0.2%) | 6 (1.1%) | 7 (1.3%) |
Total | 384 (72.5 %) | 146 (27.5 %) | 530 | |
The severity coincidence rate was 73.4% (389/530). | ||||
(B) | Mild | Severe | Total | |
PSR ≥ 80.5% | Mild | 365 (68.9%) | 73 (13.8%) | 438 (82.6%) |
PSR < 80.5% | Severe | 19 (3.6%) | 73 (13.8%) | 92 (17.4%) |
Total | 384 (72.5%) | 146 (27.5%) | 530 | |
The severity coincidence rate was 82.6% (438/530). | ||||
(C) | Mild | Severe | Total | |
ASR and PSR ≥ 80.5% | Mild | 364 (68.7%) | 68 (12.8%) | 432 (81.5%) |
ASR or PSR < 80.5% | Severe | 20 (3.8%) | 78 (14.7%) | 98 (18.5%) |
Total | 384 (72.5%) | 146 (27.5%) | 530 | |
The severity coincidence rate was 83.4% (442/530). |
No. | CA (mm) | ||||||
---|---|---|---|---|---|---|---|
Level 2 | Level 3 (Standard) | Level 4 | Level 5 | Level 6 | Level 7 | Level 8 | |
1 | 8 | 9.0 | 8.3 | 8.9 | 9.4 | 8.2 | 5.5 |
2 | 10.9 | 11.5 | 13.9 | 15.9 | 15.7 | 13.7 | 10.9 |
3 | 9.4 | 9.6 | 9.8 | 10.9 | 10.7 | 9.4 | 7.7 |
4 | 7 | 8.8 | 8.2 | 8.6 | 9.4 | 10.0 | 8.6 |
5 | 8.3 | 8.4 | 9.4 | 11.5 | 11.8 | 10.3 | 7.4 |
6 | 8.9 | 10.1 | 11.5 | 12.5 | 12.2 | 11.3 | 8.8 |
7 | 9.7 | 11.1 | 11.1 | 11.2 | 10.9 | 9.5 | 7.9 |
8 | 10.7 | 11.7 | 12.3 | 12.6 | 11.8 | 10.1 | 8.4 |
9 | 12.2 | 10.3 | 14.2 | 15.7 | 15.6 | 13.4 | 8.8 |
10 | 6.2 | 10.0 | 12.2 | 14.7 | 13.6 | 11.7 | 9.1 |
11 | 5.5 | 7.4 | 6.3 | 8.0 | 9.4 | 9.1 | 7.4 |
12 | 7.3 | 8.3 | 9.1 | 9.4 | 9.6 | 7.8 | 6.4 |
13 | 8.5 | 8.5 | 10.1 | 9.6 | 8.6 | 7.2 | 5.6 |
14 | 7.1 | 9.7 | 7.8 | 10.3 | 12.2 | 11.9 | 10.7 |
15 | 8.8 | 12.0 | 16.9 | 18.7 | 17.7 | 15.3 | 11.7 |
16 | 10.2 | 11.0 | 11.1 | 11.3 | 11.1 | 10.3 | 8.5 |
17 | 8.5 | 11.0 | 10.7 | 12.4 | 12.1 | 10.5 | 9 |
18 | 6.5 | 8.0 | 9.8 | 10.8 | 10.8 | 10.7 | 9.8 |
19 | 6.6 | 8.6 | 8.0 | 9.4 | 10.0 | 9.6 | 8.5 |
20 | 7.8 | 8.1 | 9.6 | 10.6 | 10.8 | 9.5 | 8.3 |
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Kato, R.; Nagano, N.; Hashimoto, S.; Saito, K.; Miyabayashi, H.; Noto, T.; Morioka, I. Three-Dimensional versus Two-Dimensional Evaluations of Cranial Asymmetry in Deformational Plagiocephaly Using a Three-Dimensional Scanner. Children 2022, 9, 788. https://doi.org/10.3390/children9060788
Kato R, Nagano N, Hashimoto S, Saito K, Miyabayashi H, Noto T, Morioka I. Three-Dimensional versus Two-Dimensional Evaluations of Cranial Asymmetry in Deformational Plagiocephaly Using a Three-Dimensional Scanner. Children. 2022; 9(6):788. https://doi.org/10.3390/children9060788
Chicago/Turabian StyleKato, Risa, Nobuhiko Nagano, Shin Hashimoto, Katsuya Saito, Hiroshi Miyabayashi, Takanori Noto, and Ichiro Morioka. 2022. "Three-Dimensional versus Two-Dimensional Evaluations of Cranial Asymmetry in Deformational Plagiocephaly Using a Three-Dimensional Scanner" Children 9, no. 6: 788. https://doi.org/10.3390/children9060788