Determination of reference values for normal cranial morphology by using mid-sagittal vector analysis in Japanese children

Takaya Senoo, Eijiro Tokuyama, Kiyoshi Yamada, Yoshihiro Kimata

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Mid-Sagittal Vector Analysis (MSVA) is a method of measuring the distance from a defined central point on the skull surface in the entire mid-sagittal plane and provides a clear description of the lateral view of the skull. We used a series of images of normal skulls of Japanese children to determine normal MSVA values. For this cross-sectional study, we first constructed a database of head CT and MRI images of children aged 0–6 years (41.5 ± 24.9 month (mean ± SD)) who showed no abnormality of cranial development and growth at the time of imaging. Measurement errors due to lateral shifting of the sagittal plane during MSVA were examined, CT and MRI images taken in the same patients at the same time were compared, and measurement differences were examined. Finally, MSVA was carried out, and the mean of the measured values was calculated according to age group. Two hundred ninety-five images were included in the database. When the lateral shifting of the sagittal plane was within 4 mm from the true mid-sagittal plane, the mean errors were less than 1 mm at all measurement points. Between the CT and MRI images from the same patients, most differences in MSVA values were within ±1 mm. These differences were thus acceptable for use in clinical settings. After the above verifications, 220 images were extracted for determination of normal MSVA values. We established a normal dataset of MSVA for Japanese children that can be used effectively for preoperative diagnosis, surgery planning, and postoperative assessment of cranial deformities.

Original languageEnglish
Pages (from-to)670-680
Number of pages11
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Issue number5
Publication statusPublished - May 2018


  • Cranial deformities
  • Craniosynostosis
  • Japanese children
  • Mid-sagittal vector analysis

ASJC Scopus subject areas

  • Surgery


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