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Chiari Malformations Type I without Basilar Invagination in Adults: Morphometric and Volumetric Analysis.
World Neurosurg. 2020 Aug 10 [Online ahead of print]WN

Abstract

BACKGROUND

Chiari malformation type I (CMI) cases are frequently associated with basilar invagination (BI), which complicates the understanding of the pathology of CMI. We specifically evaluated the morphometric and volumetric alterations in the bony structures of CMI patients without BI.

METHODS

Fifty adult CMI patients without BI treated at our institution from January 2015 to December 2019 were retrospectively studied. The morphometric and volumetric characteristics of the posterior cranial fossa (PCF) were analyzed using thin-slice computed tomography images.

RESULTS

Compared with the controls, the clivus length (P < 0.001), supraoccipital length (P < 0.001), Klaus height index (P < 0.001), axial length (P < 0.001), clivo-axial angle (P < 0.001), tentorial angle (P < 0.05), and bony PCF volume (P < 0.001) of the CMI-only group were significantly smaller, and the distance between the Chamberlain line and the dens axis (P < 0.001), clivus angle (P < 0.001), and basal angle (P < 0.001) of the CMI-only group were significantly larger, while the distance between the McRae line and the dens axis, McRae line, anteroposterior diameter of the PCF, occipital angle, occipital canal angle, and tentorial Twining line angle showed no significant difference between the 2 groups.

CONCLUSIONS

Hypoplasia of the clivus and occipital bone were confirmed in CMI patients without BI, thus providing further evidence for the notion that CMI is secondary to the underdevelopment of the PCF.

Authors+Show Affiliations

Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: yongzhixia@aliyun.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32791229

Citation

Wang, Shengxi, et al. "Chiari Malformations Type I Without Basilar Invagination in Adults: Morphometric and Volumetric Analysis." World Neurosurgery, 2020.
Wang S, Huang Z, Xu R, et al. Chiari Malformations Type I without Basilar Invagination in Adults: Morphometric and Volumetric Analysis. World Neurosurg. 2020.
Wang, S., Huang, Z., Xu, R., Liao, Z., Yan, Y., Tang, W., & Xia, Y. (2020). Chiari Malformations Type I without Basilar Invagination in Adults: Morphometric and Volumetric Analysis. World Neurosurgery. https://doi.org/10.1016/j.wneu.2020.08.048
Wang S, et al. Chiari Malformations Type I Without Basilar Invagination in Adults: Morphometric and Volumetric Analysis. World Neurosurg. 2020 Aug 10; PubMed PMID: 32791229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chiari Malformations Type I without Basilar Invagination in Adults: Morphometric and Volumetric Analysis. AU - Wang,Shengxi, AU - Huang,Zhijian, AU - Xu,Rui, AU - Liao,Zhengbu, AU - Yan,Yi, AU - Tang,Wenyuan, AU - Xia,Yongzhi, Y1 - 2020/08/10/ PY - 2020/06/16/received PY - 2020/08/05/accepted PY - 2020/8/14/pubmed PY - 2020/8/14/medline PY - 2020/8/14/entrez KW - Atlantoaxial instability KW - Basilar invagination KW - Chiari malformation type I KW - Craniocervical junction malformation KW - Posterior cranial fossa JF - World neurosurgery JO - World Neurosurg N2 - BACKGROUND: Chiari malformation type I (CMI) cases are frequently associated with basilar invagination (BI), which complicates the understanding of the pathology of CMI. We specifically evaluated the morphometric and volumetric alterations in the bony structures of CMI patients without BI. METHODS: Fifty adult CMI patients without BI treated at our institution from January 2015 to December 2019 were retrospectively studied. The morphometric and volumetric characteristics of the posterior cranial fossa (PCF) were analyzed using thin-slice computed tomography images. RESULTS: Compared with the controls, the clivus length (P < 0.001), supraoccipital length (P < 0.001), Klaus height index (P < 0.001), axial length (P < 0.001), clivo-axial angle (P < 0.001), tentorial angle (P < 0.05), and bony PCF volume (P < 0.001) of the CMI-only group were significantly smaller, and the distance between the Chamberlain line and the dens axis (P < 0.001), clivus angle (P < 0.001), and basal angle (P < 0.001) of the CMI-only group were significantly larger, while the distance between the McRae line and the dens axis, McRae line, anteroposterior diameter of the PCF, occipital angle, occipital canal angle, and tentorial Twining line angle showed no significant difference between the 2 groups. CONCLUSIONS: Hypoplasia of the clivus and occipital bone were confirmed in CMI patients without BI, thus providing further evidence for the notion that CMI is secondary to the underdevelopment of the PCF. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/32791229/Chiari_Malformations_Type_I_without_Basilar_Invagination_in_Adults:_Morphometric_and_Volumetric_Analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(20)31814-3 DB - PRIME DP - Unbound Medicine ER -
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