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Clivopalate angle: a new diagnostic method for basilar invagination at magnetic resonance imaging.
Eur Radiol. 2019 Jul; 29(7):3450-3457.ER

Abstract

OBJECTIVES

To investigate the diagnostic value of clivopalate angle (CPA) for basilar invagination (BI) at magnetic resonance imaging (MRI).

METHODS

In this retrospective case-control study, CPA, clivodens angle (CDA), and clivoaxial angle (CXA) were measured on midsagittal MR images from 112 patients with BI (22 men; mean age, 43.9 years ± 13.1 years; range, 21-79 years) and 200 control subjects (57 men; mean age, 47.1 years ± 13.3 years; range, 20-80 years). Intraclass correlation coefficient (ICC), linear regression, Mann-Whitney U test, binary logistic regression, and receiver operating characteristic (ROC) curve were used for statistical analysis.

RESULTS

Clivopalate angle showed better inter-observer agreement (ICC = 0.951) than CXA (0.867) or CDA (0.853). CPA significantly correlated with CXA (R = 0.811, p < 0.001) and CDA (R = 0.716, p < 0.001). Patients with BI had a significantly smaller CPA (45.9° ± 9.9°) than control subjects (61.9° ± 6.2°) (p < 0.001). With the optimal cutoff value of 53.5°, CPA had a sensitivity of 0.839 (94/112) and a specificity of 0.915 (183/200). The area under the ROC curve (AUC) was 0.937 (95% CI, 0.911-0.963) for CPA, which was similar to that of CXA (AUC, 0.957; 95% CI, 0.936-0.978) or CDA (AUC, 0.925; 95% CI, 0.892-0.957). The combination of CPA and CDA or CXA showed a higher diagnostic value than CDA or CXA alone.

CONCLUSIONS

The diagnostic performance of CPA was similar to that of CXA or CDA, but CPA might be more reliable in evaluation of BI. CPA provided complementary information to CXA and CDA.

KEY POINTS

• Clivopalate angle has a high diagnostic value for basilar invagination. • Clivopalate angle demonstrates high inter-reader agreement than does clivoaxial angle or clivodens angle. • Clivopalate angle provides complementary information to clivoaxial angle and clivodens angle.

Authors+Show Affiliations

Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, People's Republic of China.Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, People's Republic of China.Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, People's Republic of China.Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, People's Republic of China.Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, People's Republic of China.Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, People's Republic of China.Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, People's Republic of China.Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, People's Republic of China.Department of Medical Imaging, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, People's Republic of China. ripleyor@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30820721

Citation

Ma, Lichao, et al. "Clivopalate Angle: a New Diagnostic Method for Basilar Invagination at Magnetic Resonance Imaging." European Radiology, vol. 29, no. 7, 2019, pp. 3450-3457.
Ma L, Guo L, Li X, et al. Clivopalate angle: a new diagnostic method for basilar invagination at magnetic resonance imaging. Eur Radiol. 2019;29(7):3450-3457.
Ma, L., Guo, L., Li, X., Qin, J., He, W., Xiao, X., Lu, L., Xu, Y., & Wu, Y. (2019). Clivopalate angle: a new diagnostic method for basilar invagination at magnetic resonance imaging. European Radiology, 29(7), 3450-3457. https://doi.org/10.1007/s00330-018-5972-3
Ma L, et al. Clivopalate Angle: a New Diagnostic Method for Basilar Invagination at Magnetic Resonance Imaging. Eur Radiol. 2019;29(7):3450-3457. PubMed PMID: 30820721.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clivopalate angle: a new diagnostic method for basilar invagination at magnetic resonance imaging. AU - Ma,Lichao, AU - Guo,Liuji, AU - Li,Xiaodan, AU - Qin,Jie, AU - He,Wenle, AU - Xiao,Xiang, AU - Lu,Lijun, AU - Xu,Yikai, AU - Wu,Yuankui, Y1 - 2019/02/08/ PY - 2018/10/17/received PY - 2018/12/14/accepted PY - 2018/11/15/revised PY - 2019/3/2/pubmed PY - 2019/8/27/medline PY - 2019/3/2/entrez KW - Atlanto-occipital joint KW - Cephalometry KW - Clivopalate KW - Magnetic resonance imaging KW - Platybasia SP - 3450 EP - 3457 JF - European radiology JO - Eur Radiol VL - 29 IS - 7 N2 - OBJECTIVES: To investigate the diagnostic value of clivopalate angle (CPA) for basilar invagination (BI) at magnetic resonance imaging (MRI). METHODS: In this retrospective case-control study, CPA, clivodens angle (CDA), and clivoaxial angle (CXA) were measured on midsagittal MR images from 112 patients with BI (22 men; mean age, 43.9 years ± 13.1 years; range, 21-79 years) and 200 control subjects (57 men; mean age, 47.1 years ± 13.3 years; range, 20-80 years). Intraclass correlation coefficient (ICC), linear regression, Mann-Whitney U test, binary logistic regression, and receiver operating characteristic (ROC) curve were used for statistical analysis. RESULTS: Clivopalate angle showed better inter-observer agreement (ICC = 0.951) than CXA (0.867) or CDA (0.853). CPA significantly correlated with CXA (R = 0.811, p < 0.001) and CDA (R = 0.716, p < 0.001). Patients with BI had a significantly smaller CPA (45.9° ± 9.9°) than control subjects (61.9° ± 6.2°) (p < 0.001). With the optimal cutoff value of 53.5°, CPA had a sensitivity of 0.839 (94/112) and a specificity of 0.915 (183/200). The area under the ROC curve (AUC) was 0.937 (95% CI, 0.911-0.963) for CPA, which was similar to that of CXA (AUC, 0.957; 95% CI, 0.936-0.978) or CDA (AUC, 0.925; 95% CI, 0.892-0.957). The combination of CPA and CDA or CXA showed a higher diagnostic value than CDA or CXA alone. CONCLUSIONS: The diagnostic performance of CPA was similar to that of CXA or CDA, but CPA might be more reliable in evaluation of BI. CPA provided complementary information to CXA and CDA. KEY POINTS: • Clivopalate angle has a high diagnostic value for basilar invagination. • Clivopalate angle demonstrates high inter-reader agreement than does clivoaxial angle or clivodens angle. • Clivopalate angle provides complementary information to clivoaxial angle and clivodens angle. SN - 1432-1084 UR - https://www.unboundmedicine.com/medline/citation/30820721/Clivopalate_angle:_a_new_diagnostic_method_for_basilar_invagination_at_magnetic_resonance_imaging_ L2 - https://dx.doi.org/10.1007/s00330-018-5972-3 DB - PRIME DP - Unbound Medicine ER -