“Black Bone” MRI: a potential alternative to CT with three-dimensional reconstruction of the craniofacial skeleton in the diagnosis of craniosynostosis
Abstract
Objectives To determine the potential of novel gradient echo parameters, "Black Bone" MRI as an alternative to CT in the identification of normal and prematurely fused cranial sutures both in 2D and 3D imaging.Methods Thirteen children with a clinical diagnosis of craniosynostosis underwent "Black Bone" MRI in addition to routine cranial CT. "Black Bone" datasets were compared to CT and clinical findings. "Black Bone" imaging was subsequently used to develop 3D reformats of the craniofacial skeleton to enhance further visualisation of the cranial sutures.Results Patent cranial sutures were consistently identified on "Black Bone" MRI as areas of increased signal intensity. In children with craniosynostosis the affected suture was absent, whilst the remaining patent sutures could be visualised, consistent with CT and clinical findings. Segmentation of the "Black Bone" MRI datasets was successful with both threshold and volume rendering techniques. The cranial sutures, where patent, could be visualised throughout their path.Conclusions Patent cranial sutures appear as areas of increased signal intensity on "Black Bone" MRI distinct from the cranial bone, demonstrating considerable clinical potential as a non-ionising alternative to CT in the diagnosis of craniosynostosis.Key points • Patent cranial sutures appear hyperintense on "Black Bone" MRI • Prematurely fused cranial sutures are distinct from patent sutures • Minimal soft tissue contrast permits 3D-rendered imaging of the craniofacial skeleton.
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Eley et al. (2014) found that black bone MRI in 13 children with craniosynostosis showed physiological sutures contrasting from cranial bones with increased signal intensity while prematurely closed ones do not, indicating potential for radiation-free diagnosis.
“As a pioneering new alternative to conventional CT imaging, Eley et al. (2014) examined the so-called “black bone MRI” (in 2D and 3D).”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [32]
Eley et al. examined 'black bone MRI', which enables precise cranial suture assessment without radiation but necessitates anaesthesia in young children.
“Eley et al. examined the “black bone MRI”, which enables precise cranial suture assessment without radiation but necessitates anaesthesia in young children [5, 32, 33]”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [32]
Sonography up to 13 months of age can distinguish an open from a closed suture with a reported sensitivity of 100% and specificity of 86-98%, without anaesthesia.
“sonography up to 13 months of age can distinguish an open from a closed suture with a reported sensitivity of 100% and specificity of 86–98% [2, 32], without any necessary anaesthesia.”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [32]
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“…examined the “black bone MRI”, which enables precise cranial suture assessment without radiation but necessitates anaesthesia in young children [5, 32, 33], while sonography up to 13 months of age can distinguish an open from a closed suture with a reported sensitivity of 100% and specificity of…”
Influential
- Authors
- Eley, K. A., Watt-Smith, S. R., Sheerin, F., & Golding, S. J.
- Affiliations
- University of Cambridge (GB)
- John Radcliffe Hospital (GB)
- Corresponding author
- Eley, Karen A.
- Venue
- European Radiology
- Published
- 2014-07-20
- Volume
- 24
- Issue
- 10
- Pages
- 2417-2426
- ISSN
- 0938-7994 (ISSN-L)
- 1432-1084
- OpenAlex
- W1964200564
- Cited by
- 136
- References
- 19
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 10 · 2023: 8 · 2022: 18 · 2021: 15 · 2020: 21 · 2019: 15 · 2018: 11 · 2017: 8 · 2016: 3 · 2015: 4 · 2013: 1
- FWCI
- 3.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Radiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Radiological Society of North America
- Newlife the Charity for Disabled Children
- National Institute for Health and Care Research (ACF-2013-14-008)
- AO Foundation
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Keywords
- black bone MRI, craniosynostosis, cranial sutures, premature suture fusion, gradient-echo imaging, volume rendering
- MeSH terms
- Child, Child, Preschool, Cranial Sutures, Craniosynostoses, Female, Humans, Infant, Magnetic Resonance Imaging, Male, Retrospective Studies, Tomography, X-Ray Computed, Reproducibility of Results, Imaging, Three-Dimensional
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