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Posterior Fossa Measurements in Patients With and Without Chiari I Malformation

Published online by Cambridge University Press:  02 December 2014

John A. Dufton
Affiliation:
Department of Diagnostic Radiology, Kingston General Hospital, Queen's University
Syed Yaser Habeeb
Affiliation:
Queen's University School of Medicine, Kingston
Manraj K. S. Heran
Affiliation:
Department of Radiology, Vancouver General Hospital, Children & Women's Health Centre BC, University of British Columbia, Vancouver, British Columbia, Canada
David J. Mikulis
Affiliation:
Toronto Western Hospital, McLaughlin Pavilion, Toronto, Ontario
Omar Islam
Affiliation:
Department of Diagnostic Radiology, Kingston General Hospital, Queen's University
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Abstract

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Purpose:

To determine if there is a correlation between cerebellar tonsillar descent in patients with and without Chiari I malformation and three skull morphometric measurements: clivus length, anteroposterior diameter of the foramen magnum, and Boogard's angle.

Methods:

Cerebellar tonsillar descent, clivus length, anteroposterior diameter of the foramen magnum, and Boogard's angle were measured in mid-sagittal T1-weighted magnetic resonance images of 188 patients. The study included 81 patients with Chiari I malformations (CMI). Without identifiable pathology, 107 patients served as a comparison group. Two-sample t-tests were used to assess for significance. A Pearson correlation matrix was constructed to assess the strength of linear dependence between measured parameters for the study population.

Results:

A negative correlation was found between tonsillar herniation and clivus length (r = -0.30, P < 0.001), while a positive correlation was found between tonsillar herniation and foramen magnum size (r = 0.15, P = 0.0431), and Boogard's angle (r = 0.23, P = 0.0014). Clivus length was shorter (P = 0.0009) in CMI patients (4.02 cm ± 0.45) than comparison patients (4.23 cm ± 0.42). In addition, the anteroposterior diameter of the foramen magnum was wider (P = 0.0412) (3.74 cm ± 0.40 compared to 3.63 ± 0.30) and Boogard's angle was larger (P = 0.0079) (123.58 degrees ± 8.27 compared to 120.62 degrees ± 6.79) with CMI.

Conclusion:

A greater degree of cerebellar tonsillar herniation is associated with a shorter clivus length, a wider anteroposterior diameter of foramen magnum, and a wider Boogard's angle.

Type
Original Article
Copyright
Copyright © The Canadian Journal of Neurological 2011

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