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Chiari 畸形各亚型中后颅窝及颅颈交界区的形态学分析

Morphometric analysis of posterior fossa and craniovertebral junction in subtypes of Chiari malformation.

作者信息

Basaran Recep, Efendioglu Mustafa, Senol Mehmet, Ozdogan Selcuk, Isik Nejat

机构信息

Medeniyet University Goztepe Education and Research Hospital, Department of Neurosurgery, Istanbul, Turkey.

Medeniyet University Goztepe Education and Research Hospital, Department of Neurosurgery, Istanbul, Turkey.

出版信息

Clin Neurol Neurosurg. 2018 Jun;169:1-11. doi: 10.1016/j.clineuro.2018.03.017. Epub 2018 Mar 20.

DOI:10.1016/j.clineuro.2018.03.017
PMID:29587156
Abstract

OBJECTIVES

Chiari malformations (CMs) are a group of disorders defined by anatomic anomalies of the cerebellum, brainstem, and craniovertebral junction (CVJ). In this study, we aimed to investigate morphometry of posterior fossa and CVJ in subtypes of CM and in control group, and to bring up a matter a correlation with demographic data and subtypes of CM.

PATIENTS AND METHODS

The study group included patients managed for CM between 2012 and 2016 and control group. Radiological evaluation was studied by special programs and formulas. Intracranial volumes and morphometric datas of posterior fossa and CVJ were recorded retrospectively.

RESULTS

Of the 141 patients, 91 had CM and 50 were control group participants. Mean age was 34.75. Patients were classified as CM-0 (n:10), CM-1 (n:45), CM-1.5 (n:21), CM-2 (n:15). There were statistically significance between Chiari subtypes by syringomyelia (SM) presence (p ˂ 0.01), SM localization (p ˂ 0.01), posterior fossa volume (PFV) (p ˂ 0.01), length of clivus (LoC) and length of subocciput (LoSO) (p ˂ 0.01 for both), angle between clivus and subocciput (C-SO angle) (p ˂ 0.01), and clivo-dental angle (C-D angle) (p ˂ 0.01).

CONCLUSION

On morphometric comparison of CM subtypes we concluded that etiological differences lead to morphological differences. CM-2 has remarkable differences from both other subtypes and the control group.

摘要

目的

Chiari畸形(CMs)是一组由小脑、脑干和颅颈交界区(CVJ)解剖异常所定义的疾病。在本研究中,我们旨在研究CM各亚型及对照组后颅窝和CVJ的形态学特征,并探讨其与人口统计学数据及CM亚型之间的相关性。

患者与方法

研究组包括2012年至2016年间接受CM治疗的患者及对照组。通过特殊程序和公式进行放射学评估。回顾性记录颅内体积以及后颅窝和CVJ的形态学数据。

结果

141例患者中,91例患有CM,50例为对照组参与者。平均年龄为34.75岁。患者被分为CM-0型(n = 10)、CM-1型(n = 45)、CM-1.5型(n = 21)、CM-2型(n = 15)。Chiari各亚型在是否存在脊髓空洞症(SM)(p<0.01)、SM定位(p<0.01)、后颅窝体积(PFV)(p<0.01)、斜坡长度(LoC)和枕下长度(LoSO)(两者均p<0.01)、斜坡与枕下之间的角度(C-SO角)(p<0.01)以及斜坡-齿状突角(C-D角)(p<0.01)方面存在统计学差异。

结论

通过对CM各亚型的形态学比较,我们得出病因差异导致形态学差异的结论。CM-2型与其他亚型及对照组均存在显著差异。

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