Anatomy Department, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey.
Neurosurgery Department, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Childs Nerv Syst. 2023 Jun;39(6):1581-1587. doi: 10.1007/s00381-023-05833-3. Epub 2023 Jan 13.
Chiari malformation type 1 (CM-1) is a posterior fossa anomaly characterized by herniation of the cerebellar tonsils from the foramen magnum (FM). This study compares FM, medulla spinalis (MS), and herniated cerebellar tonsils ratios by making area measurements from axial plane MRI in CM-1 patients and the control group.
Our study evaluated 30 pediatric patients with CM-1 and 30 people in the control group. The lengths of the McRae line, twining line, and clivus line were measured on the posterior cranial fossa evaluation. The areas of FM (A), MS (A), and herniated cerebellar tonsils (A) were measured by axial images.
As a result of area measurements obtained from axial cross-sectional MRI, a statistically significant difference was found between CM-1 patients and the control group. According to the results of the ROC analysis, if an individual's A/A value is above 17.9% or the A/A value is above 18.4%, it can be interpreted as a CM-1 patient.
It will be easier to diagnose the patient with the new approach we obtained from axial MR images in addition to sagittal MR images. This method can be a guide in some cases when the surgeons are undecided.
Chiari 畸形 1 型（CM-1）是一种后颅窝异常，其特征是小脑扁桃体从枕骨大孔（FM）疝出。本研究通过对 CM-1 患者和对照组的轴位 MRI 进行面积测量，比较 FM、脊髓（MS）和疝出的小脑扁桃体的比例。
我们的研究评估了 30 名小儿 CM-1 患者和 30 名对照组。在后颅窝评估中测量 McRae 线、扭结线和斜坡线的长度。通过轴位图像测量 FM（A）、MS（A）和疝出的小脑扁桃体（A）的面积。
通过轴位 MRI 获得的面积测量结果，CM-1 患者与对照组之间存在统计学显著差异。根据 ROC 分析的结果，如果个体的 A/A 值大于 17.9%或 A/A 值大于 18.4%，则可以将其解释为 CM-1 患者。
除了矢状位 MRI 之外，通过新的轴位 MRI 方法可以更容易地诊断患者。在某些情况下，当外科医生犹豫不决时，该方法可以作为指导。
