Get access

MRI-based Morphometric Analysis of Posterior Cranial Fossa in the Diagnosis of Chiari Malformation Type I

Authors

  • Aintzane Urbizu BSc,

    1. Pediatric Neurology Research Group, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona
    Search for more papers by this author
  • Maria-Antonia Poca MD,

    1. Department of Neurosurgery and Neurotraumatology and Neurosurgery Research Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona
    Search for more papers by this author
  • Xavier Vidal MD,

    1. Servei de Medicina Preventiva, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona
    Search for more papers by this author
  • Alex Rovira MD,

    1. Magnetic Resonance Unit (IDI), Department of Radiology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona
    Search for more papers by this author
  • Juan Sahuquillo MD,

    1. Department of Neurosurgery and Neurotraumatology and Neurosurgery Research Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona
    Search for more papers by this author
  • Alfons Macaya MD

    Corresponding author
    1. Pediatric Neurology Research Group, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona
    • Correspondence: Address correspondence to Dr. Alfons Macaya, Grup de Recerca en Neurologia Pediàtrica, Vall d’Hebron Institut de Recerca, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain, Tel: +34 934893890, Fax: +34 932746837. E-mail: amacaya@vhebron.net.

    Search for more papers by this author

  • Funding sources: This work was supported by grants of Instituto de Salud Carlos III, Spain, grant PI061606, Fundació La Marató TV3, Spain, grant 062710 and Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR), Spain, grant 2009SGR -0078. A.U. is the recipient of a scholarship from AGAUR (Spain).

  • Conflict of interest: We declare that we have no conflict of interest.

ABSTRACT

BACKGROUND AND PURPOSE

The diagnosis of Chiari malformation type I (CMI) relies on MRI identification of a tonsillar descent (TD) through the foramen magnum, reflecting the overcrowding of an underdeveloped posterior cranial fossa (PCF). However, TD occurs in some patients with normal-sized PCF and, conversely, some patients with borderline or no TD have small PCF. We thus sought to identify a set of prototypic PCF measures for the diagnosis of CMI.

METHODS

We performed nineteen measurements of the PCF on sagittal MRI of 100 cases with cerebellar TD ≥5 mm and 50 control individuals, compared the average values in both cohorts and used logistic regression to devise a probability model to predict CMI status.

RESULTS

Significant decrements were detected for several PCF-related measures in the patients’ cohort. We developed a probability model that combined seven of these parameters to predict diagnosis with 93% sensitivity and 92% specificity.

CONCLUSIONS

The addition of simple morphometric measurements in the diagnostic work-up of patients with suspected CMI may facilitate radiological diagnosis. Moreover, identification of the subset of CMI that arise from basichondrocranium underdevelopment is important for both, selection of the most appropriate therapeutic approach as well as proper CMI categorization in research studies.

Get access to the full text of this article

Ancillary