Radiological Examinations

How does radiological imaging help to the diagnosis of craniofacial malformations?

The diagnosis of craniofacial malformations starts from the clinical examination that is performed by the craniofacial surgeon. At the end of the clinical examination it is likely to be asked from the patient to make a CT or MRI. This is happened because these tests give the doctor the opportunity to assess in detail the skeleton of the skull and face as well as the central nervous system (CNS). More specifically:

  • A CT scan is able to show the skeletal molecules, helping to a detailed assessment of the craniofacial skeleton morphology. 
  • An MRI is able to show the soft tissues, presenting analytically the state of the brain.

In a second time, if the surgical repair of the case is considered necessary, the imaging tests play an important role in the surgical planning.


What should you know before you make a CT or MRI scan:

  • Both CT and MRI are not painful examinations. CT takes less than 1 minute, while the MRI takes about half an hour.
  • In infants and children, it is required general anesthesia in order not to move at all during the examination. (If there is some kind of movement during the scan, the image quality is altered)
  • During CT, the patient is exposed to radiation, while in MRI not.


Note that:

  • The radiation has been implicated in causing cancer and therefore should make every effort to reduce the dose to get the child's organs. Make sure that the center where makes CT scans applies strict protocols that prescribe low radiation doses for CT scans in children.
  • With the use of low-dose radiation protocol, the radiation that the child takes is 20-fold reduced in relation to an adult’s protocol.
  • The radiation dose that the patient takes it has been recorded by modern computed tomography machines.
  • The factors that determine the radiation dose is mA (milli Ampere) and KV (kilo volt).
    • The mA determine the number of photons while KV their permeability.
    • Reduction of mA and KV results in a drastic decrease of the radiation dose without diminishing the quality of bone imaging.
    • Reduction of KV decreases the image quality of the soft tissues, something that is not so important since the soft tissues perfectly illustrated by MRI, which is usually done at the same date with the CT scan. 


Do not forget:

  • CT scan should not be done if it is not absolutely necessary
  • CT and MRI scan should always be done in consultation with the doctor that you have chosen for the surgical repair of the case. The doctor should be responsible to decide all the details.
  • The clinical team and the staff of the radiological center must be in communication with the doctor about the details of each medical examination.
  • You must always ask from the doctor the record of your examinations in CD, in order to allow their reproduction and their further processing with special software.