Department of Psychology, Conquer Chiari Research Center, The University of Akron, Akron, OH, 44325, USA.
Department of Biomedical Engineering, Conquer Chiari Research Center, The University of Akron, Akron, OH, 44325, USA.
J Neuroradiol. 2018 Feb;45(1):23-31. doi: 10.1016/j.neurad.2017.06.006. Epub 2017 Aug 18.
Type I Chiari malformation (CMI) is a radiologically-defined structural dysmorphism of the hindbrain and posterior cranial fossa (PCF). Traditional radiographic identification of CMI relies on the measurement of the cerebellar tonsils in relation to the foramen magnum with or without associated abnormalities of the neuraxis. The primary goal of this retrospective study was to comprehensively assess morphometric parameters above the McRea line in a group of female CMI patients and normal controls.
Twenty-nine morphological measurements were taken on 302 mid-sagittal MR images of adult female CMI patients (n=162) and healthy controls (n=140). All MR images were voluntarily provided by CMI subjects through an online database and control participant images were obtained through the Human Connectome Project and a local hospital system.
Analyses were performed on the full dataset of adult female MR images and a restricted dataset of 229 participants that were equated for age, race, and body mass index. Eighteen group differences were identified in the PCF area that we grouped into three clusters; PCF structures heights, clivus angulation, and odontoid process irregularity. Fourteen group differences persisted after equating our CMI and control groups on demographic characteristics.
PCF structures reliably differ in adult female CMI patients relative to healthy controls. These differences reflect structural abnormalities in the osseous and soft tissue structures of the clivus, odontoid process, and cerebellum. Clinical and pathophysiological implications are discussed.
I 型 Chiari 畸形（CMI）是一种后颅窝（PCF）后脑和颅后窝的影像学定义结构畸形。传统的 CMI 放射学诊断依赖于小脑扁桃体与枕大孔之间的关系的测量，伴有或不伴有神经轴的相关异常。本回顾性研究的主要目的是全面评估一组女性 CMI 患者和正常对照组中 McRea 线以上的形态参数。
对 302 名成年女性 CMI 患者（n=162）和健康对照组（n=140）的 302 个正中矢状面 MRI 图像进行了 29 项形态学测量。所有的 MRI 图像都是通过在线数据库由 CMI 患者自愿提供的，对照组的图像是通过人类连接组计划和当地医院系统获得的。
对所有成年女性 MRI 图像的全数据集和 229 名参与者的受限数据集进行了分析，这些参与者在年龄、种族和体重指数方面是匹配的。在 PCF 区域确定了 18 个组间差异，我们将这些差异分为三个簇；PCF 结构高度、斜坡角度和齿状突不规则。在对我们的 CMI 和对照组进行人口统计学特征匹配后，有 14 个组间差异仍然存在。
与健康对照组相比，成年女性 CMI 患者的 PCF 结构确实存在差异。这些差异反映了斜坡、齿状突和小脑的骨和软组织结构的结构异常。讨论了临床和病理生理意义。
