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Magnetic resonance imaging features of complex Chiari malformation variant of Chiari 1 malformation.
Pediatr Radiol. 2014 Nov; 44(11):1403-11.PR

Abstract

BACKGROUND

Complex Chiari malformation is a subgroup of Chiari 1 malformation with distinct imaging features. Children with complex Chiari malformation are reported to have a more severe clinical phenotype and sometimes require more extensive surgical treatment than those with uncomplicated Chiari 1 malformation.

OBJECTIVE

We describe reported MR imaging features of complex Chiari malformation and evaluate the utility of craniometric parameters and qualitative anatomical observations for distinguishing complex Chiari malformation from uncomplicated Chiari 1 malformation.

MATERIALS AND METHODS

We conducted a retrospective search of the institutional imaging database using the keywords "Chiari" and "Chiari 1" to identify children imaged during the 2006-2011 time period. Children with Chiari 2 malformation were excluded after imaging review. We used the first available diagnostic brain or cervical spine MR study for data measurement. Standard measurements and observations were made of obex level (mm), cerebellar tonsillar descent (mm), perpendicular distance to basion-C2 line (pB-C2, mm), craniocervical angle (degrees), clivus length, and presence or absence of syringohydromyelia, basilar invagination and congenital craniovertebral junction osseous anomalies. After imaging review, we accessed the institutional health care clinical database to determine whether each subject clinically met criteria for Chiari 1 malformation or complex Chiari malformation.

RESULTS

Obex level and craniocervical angle measurements showed statistically significant differences between the populations with complex Chiari malformation and uncomplicated Chiari 1 malformation. Cerebellar tonsillar descent and perpendicular distance to basion-C2 line measurements trended toward but did not meet statistical significance. Odontoid retroflexion, craniovertebral junction osseous anomalies, and syringohydromyelia were all observed proportionally more often in children with complex Chiari malformation than in those with Chiari 1 malformation.

CONCLUSION

Characteristic imaging features of complex Chiari malformation, especially obex level, permit its distinction from the more common uncomplicated Chiari 1 malformation.

Authors+Show Affiliations

Department of Medical Imaging, Primary Children's Medical Center, 100 N. Mario Capecchi Drive, Salt Lake City, UT, 84113, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24898393

Citation

Moore, Hannah E., and Kevin R. Moore. "Magnetic Resonance Imaging Features of Complex Chiari Malformation Variant of Chiari 1 Malformation." Pediatric Radiology, vol. 44, no. 11, 2014, pp. 1403-11.
Moore HE, Moore KR. Magnetic resonance imaging features of complex Chiari malformation variant of Chiari 1 malformation. Pediatr Radiol. 2014;44(11):1403-11.
Moore, H. E., & Moore, K. R. (2014). Magnetic resonance imaging features of complex Chiari malformation variant of Chiari 1 malformation. Pediatric Radiology, 44(11), 1403-11. https://doi.org/10.1007/s00247-014-3021-1
Moore HE, Moore KR. Magnetic Resonance Imaging Features of Complex Chiari Malformation Variant of Chiari 1 Malformation. Pediatr Radiol. 2014;44(11):1403-11. PubMed PMID: 24898393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnetic resonance imaging features of complex Chiari malformation variant of Chiari 1 malformation. AU - Moore,Hannah E, AU - Moore,Kevin R, Y1 - 2014/06/05/ PY - 2013/11/26/received PY - 2014/04/28/accepted PY - 2014/02/14/revised PY - 2014/6/6/entrez PY - 2014/6/6/pubmed PY - 2015/6/24/medline SP - 1403 EP - 11 JF - Pediatric radiology JO - Pediatr Radiol VL - 44 IS - 11 N2 - BACKGROUND: Complex Chiari malformation is a subgroup of Chiari 1 malformation with distinct imaging features. Children with complex Chiari malformation are reported to have a more severe clinical phenotype and sometimes require more extensive surgical treatment than those with uncomplicated Chiari 1 malformation. OBJECTIVE: We describe reported MR imaging features of complex Chiari malformation and evaluate the utility of craniometric parameters and qualitative anatomical observations for distinguishing complex Chiari malformation from uncomplicated Chiari 1 malformation. MATERIALS AND METHODS: We conducted a retrospective search of the institutional imaging database using the keywords "Chiari" and "Chiari 1" to identify children imaged during the 2006-2011 time period. Children with Chiari 2 malformation were excluded after imaging review. We used the first available diagnostic brain or cervical spine MR study for data measurement. Standard measurements and observations were made of obex level (mm), cerebellar tonsillar descent (mm), perpendicular distance to basion-C2 line (pB-C2, mm), craniocervical angle (degrees), clivus length, and presence or absence of syringohydromyelia, basilar invagination and congenital craniovertebral junction osseous anomalies. After imaging review, we accessed the institutional health care clinical database to determine whether each subject clinically met criteria for Chiari 1 malformation or complex Chiari malformation. RESULTS: Obex level and craniocervical angle measurements showed statistically significant differences between the populations with complex Chiari malformation and uncomplicated Chiari 1 malformation. Cerebellar tonsillar descent and perpendicular distance to basion-C2 line measurements trended toward but did not meet statistical significance. Odontoid retroflexion, craniovertebral junction osseous anomalies, and syringohydromyelia were all observed proportionally more often in children with complex Chiari malformation than in those with Chiari 1 malformation. CONCLUSION: Characteristic imaging features of complex Chiari malformation, especially obex level, permit its distinction from the more common uncomplicated Chiari 1 malformation. SN - 1432-1998 UR - https://www.unboundmedicine.com/medline/citation/24898393/Magnetic_resonance_imaging_features_of_complex_Chiari_malformation_variant_of_Chiari_1_malformation_ L2 - https://dx.doi.org/10.1007/s00247-014-3021-1 DB - PRIME DP - Unbound Medicine ER -