Measuring the head circumference on MRI in children: an interrater study

Abstract: Purpose
The head circumference is typically used as a surrogate parameter for the development of the central nervous system and intracranial structures and is an important clinical parameter in neuropediatrics. As magnetic resonance images (MRI) can be freely zoomed, visual analysis of the head size often relies on impressions, such as the craniofacial ratio or a simplified gyral pattern. Aim of this study was to validate an MRI-based method to measure the head circumference.

Methods
Head circumferences of 85 children (41 microcephalies, 22 macrocephalies and 22 normal controls; 47 male, mean age 3.22 ± 2.45 years, range 0.19–10.42 years) were retrospectively measured using sagittal 3D-T1w (MPRAGE) data sets. Three readers independently placed an ovoid region of interest in an axial plane starting from the supraorbital bulge and covering the largest supra-auricular head circumference. Clinical measurements of the head circumference taken within an acceptable period served for comparative purposes. Reliability was assessed by calculating the total error of measurement (TEM) and the intraclass correlation coefficient (ICC).

Results
A close correlation was found between MRI-based and clinical measurements. The interrater reliability was excellent (ICC 0.985, 95% confidence interval 0.952–0.993). Absolute TEM ranged from 0.47–0.75, resulting in relative TEM ranging from 1.0–1.6%. Thus, TEMs were classified as acceptable. The mean accuracy of MRI-based measurements was high at 0.94.

Conclusion
The head circumference can be reliably determined with a simple measurement on 3D sequences using multiplanar reformations. This approach may help to diagnose microcephaly and macrocephaly, especially when the head circumference is not reported by the referring physician

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch
• Notes: Clinical neuroradiology. - 31 (2021) , 1021–1027, ISSN: 1869-1447

Contributors, Places and Time

• Event: Veröffentlichung
• (where): Freiburg
• (who): Universität
• (when): 2021
• Creator: Rau, Alexander ; Demerath, Theo ; Kremers, Nico ; Eckenweiler, Matthias ; Warth, Rieka von der ; Urbach, Horst

Further information

• DOI: 10.1007/s00062-021-01019-z
• URN: urn:nbn:de:bsz:25-freidok-2189783
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:30 AM CEST