Öz
Purpose: The aim of this study is to evaluate the morphological changes in Magnetic Resonance Images (MRI) of Chiari Malformation Type-1 (CMI) patients by performing morphometric measurements of fossa cranii posterior (FCP) and cranium.
Materials and Methods: Our study is retrospective and included a control group of 32 (16 females, 16 males) and 12 patients (6 males, 6 females) with CMI between the ages of 21 and 47 years. Measurements were made on T2-weighted cranial MR images of the patient with CMI and the control group.
Results: Maximum cranial length, maximum cranial height, sagittal diameter of foramen magnum, cranium base length, supraocciput, clivus length, anterior-posterior diameter of fossa cranii posterior, occipital cord length, cerebellum height, amount of herniation in CMI were found 164.13±10.67mm, 134.60±10.71mm, 36.89±5.28mm, 108.5±7.9mm, 38.5±3.7 mm, 36.7±7.1mm, 84.9±8.8mm, 79.7±11.5mm, 53.3±4.2mm, 7.8±4.9mm respectively.
Conclusion: In our study, the measurements of the CMI and the control group were compared and a decrease in the length of the supraocciput, the length of the clivus and the length of the occipital cord has been found and an increase in the length of the cranial base and the sagittal diameter of the foramen magnum has been found in CMI patients. As a result of the data obtained in our study, FCP morphometry of patients with CMI can contribute to patient follow-up and surgery.
Anahtar Kelimeler
: Fossa cranii posterior tonsillary herniation Chiari malformation
Kaynakça
- 1. Moore KL, Dalley AF. Clinically oriented anatomy. In: Kelly PJ editor. 4th ed. Baltimore, p.845, 1999.
- 2. Dagtekin A, Avci E, Kara E, Uzmansel D, Dagtekin O, Koseoglu A et al. Posterior cranial fossa morphometry in symptomatic adult Chiari I malformation patients: comparative clinical and anatomical study. Clin Neurol Neurosurg. 2011;113:399-403.
- 3. Furtado SV, Reddy K, Hegde AS. Posterior fossa morphometry in symptomatic pediatric and adult Chiari I malformation. J Clin Neurosci. 2009;16:1449-54.
- 4. Urbizu A, Poca MA, Vidal X, Rovira A, Sahuquillo J, Macaya A. MRI-based morphometric analysis of posterior cranial fossa in the diagnosis of chiari malformation type I. J Neuroimaging. 2014;24:250-6.
- 5. Stovner LJ, Bergan U, Nilsen G, Sjaastad O. Posterior cranial fossa dimensions in the Chiari I malformation: relation to pathogenesis and clinical presentation. Neuroradiology. 1993;35:113-8.
- 6. Tastemur Y, Sabanciogulları V, Salk İ, Sönmez M, Cimen M. The relationship of the posterior cranial fossa, the cerebrum, and cerebellum morphometry with tonsiller herniation. Iranian Journal of Radiology. 2017;14.
- 7. Sekula RF Jr, Jannetta PJ, Casey KF, Marchan EM, Sekula LK, McCrady CS. Dimensions of the posterior fossa in patients symptomatic for Chiari I malformation but without cerebellar tonsillar descent. Cerebrospinal Fluid Res. 2005;2:11.
- 8. Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson BS. Asymptomatic Chiari Type I malformations identified on magnetic resonance imaging. J Neurosurg. 2000;92:920-6.
- 9. Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, Speer MC. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery. 1999;44:1005-17.
- 10. Barkovich AJ, Wippold FJ, Sherman JL, Citrin CM. Significance of cerebellar tonsillar position on MR. AJNR Am J Neuroradiol. 1986;7:795-9.
- 11. Ishikawa M, Kikuchi H, Fujisawa I, Yonekawa Y. Tonsillar herniation on magnetic resonance imaging. Neurosurgery. 1988;22:77-81.
- 12. Oakes WJ, Tubbs RS. Chiari malformations. In: Winn HR, editor. Youmans Neurological Surgery. 5th Ed.p.3347–61, 2004.
- 13. Milhorat TH, Bolognese PA, Nishikawa M, McDonnell NB, Francomano CA. Syndrome of occipitoatlantoaxial hypermobility, cranial settling, and chiari malformation type I in patients with hereditary disorders of connective tissue. J Neurosurg Spine. 2007;7:601-9.
- 14. Schady W, Metcalfe RA, Butler P. The incidence of craniocervical bony anomalies in the adult Chiari malformation. J Neurol Sci. 1987;82:193-203. 15. James HE, Brant A. Treatment of the Chiari malformation with bone decompression without durotomy in children and young adults. Childs Nerv Syst. 2002;18:202-6.
- 16. Di Lorenzo N, Cacciola F. Adult syringomielia. Classification, pathogenesis and therapeutic approaches. J Neurosurg Sci. 2005;49:65-72.
- 17. Nishikawa M, Sakamoto H, Hakuba A, Nakanishi N, Inoue Y. Pathogenesis of Chiari malformation: a morphometric study of the posterior cranial fossa. J Neurosurg. 1997;86:40-7.
- 18. Marin-Padilla M, Marin-Padilla TM. Morphogenesis of experimentally induced Arnold-Chiari malformation. J Neurol Sci. 1981;50:29-55.
- 19. Aydin S, Hanimoglu H, Tanriverdi T, Yentur E, Kaynar MY. Chiari type I malformations in adults: a morphometric analysis of the posterior cranial fossa. Surg Neurol. 2005;64:237-41.
- 20. Tubbs RS, Iskandar BJ, Bartolucci AA, Oakes WJ. A critical analysis of the Chiari 1.5 malformation. J Neurosurg. 2004;101:179-83. 21. Noudel R, Jovenin N, Eap C, Scherpereel B, Pierot L, Rousseaux P. Incidence of basioccipital hypoplasia in Chiari malformation type I: comparative morphometric study of the posterior cranial fossa. Clinical article. J Neurosurg. 2009;111:1046-52.
- 22. Hwang HS, Moon JG, Kim CH, Oh SM, Song JH, Jeong JH. The comparative morphometric study of the posterior cranial fossa : what is effective approaches to the treatment of Chiari malformation type 1. J Korean Neurosurg Soc. 2013;54:405-10.
- 23. Vega A, Quintana F, Berciano J. Basichondrocranium anomalies in adult Chiari type I malformation: a morphometric study. J Neurol Sci. 1990;99:137-45. 24. Mikulis DJ, Diaz O, Egglin TK, Sanchez R. Variance of the position of the cerebellar tonsils with age: preliminary report. Radiology. 1992;183:725-8.
Chiari malformasyonu Tip-I’de fossa cranii posterior morfometrisinin radyolojik olarak değerlendirilmesi
Öz
Amaç:. Bu çalışmada, Chiari Malformasyonu Tip-I hastaları ve kontrol grubuna ait Manyetik Rezonans (MR) görüntülerinde fossa cranii posterior (FCP) ve cranium’ a ait morfometrik ölçümler yapılarak oluşan morfolojik değişiklikleri değerlendirmek amaçlandı.
Gereç ve Yöntem: Çalışmamız retrospektif nitelikte olup çalışmaya 21 ve 47 yaş aralığında 32 kişilik kontrol grubu (16 kadın, 16 erkek) ve 12 kişilik CMI’ lı hasta grubu (6 erkek, 6 kadın) dahil edildi. CMI’ lı hasta ve kontrol grubuna ait T2 ağırlıklı MR görüntüleri üzerinde ölçümler yapıldı.
Bulgular: Maksimum cranial uzunluk, maksimum cranial yükseklik, foramen magnum sagittal çapı, basis cranii uzunluğu, supraocciput uzunluğu, clivus uzunluğu, fossa cranii posterior’ un ön-arka çapı, occipital cord uzunluğu, cerebellum yüksekliği, herniasyon miktarı CMI’ lı hastalarda sırasıyla 164.13±10.67mm, 134.60 ±10.71 mm, 36.89±5.28 mm, 108.5±7.9 mm, 38.5±3.7 mm, 36.7±7.1 mm, 84.9±8.8 mm, 79.7±11.5 mm, 53.3±4.2 mm, 7.8±4.9 mm olarak ölçüldü.
Sonuç: Sağlıklı bireylere ait değerlerle karşılaştırıldığında, CMI’lı hastalarda foramen magnum ön-arka çapında ve tonsiller herniasyonda artış; clivus uzunluğu, occipital cord uzunluğu ve supraocciput uzunluğunda azalma olduğu görüldü. CMI‘lı hastalara ait FCP morfometrisinin bilinmesinin hastaların takibine ve cerrahisine katkı sağlayacağı düşünüldü.
Anahtar Kelimeler
: Fossa cranii posterior tonsiller herniasyon Chiari malformasyonu
Kaynakça
- 1. Moore KL, Dalley AF. Clinically oriented anatomy. In: Kelly PJ editor. 4th ed. Baltimore, p.845, 1999.
- 2. Dagtekin A, Avci E, Kara E, Uzmansel D, Dagtekin O, Koseoglu A et al. Posterior cranial fossa morphometry in symptomatic adult Chiari I malformation patients: comparative clinical and anatomical study. Clin Neurol Neurosurg. 2011;113:399-403.
- 3. Furtado SV, Reddy K, Hegde AS. Posterior fossa morphometry in symptomatic pediatric and adult Chiari I malformation. J Clin Neurosci. 2009;16:1449-54.
- 4. Urbizu A, Poca MA, Vidal X, Rovira A, Sahuquillo J, Macaya A. MRI-based morphometric analysis of posterior cranial fossa in the diagnosis of chiari malformation type I. J Neuroimaging. 2014;24:250-6.
- 5. Stovner LJ, Bergan U, Nilsen G, Sjaastad O. Posterior cranial fossa dimensions in the Chiari I malformation: relation to pathogenesis and clinical presentation. Neuroradiology. 1993;35:113-8.
- 6. Tastemur Y, Sabanciogulları V, Salk İ, Sönmez M, Cimen M. The relationship of the posterior cranial fossa, the cerebrum, and cerebellum morphometry with tonsiller herniation. Iranian Journal of Radiology. 2017;14.
- 7. Sekula RF Jr, Jannetta PJ, Casey KF, Marchan EM, Sekula LK, McCrady CS. Dimensions of the posterior fossa in patients symptomatic for Chiari I malformation but without cerebellar tonsillar descent. Cerebrospinal Fluid Res. 2005;2:11.
- 8. Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson BS. Asymptomatic Chiari Type I malformations identified on magnetic resonance imaging. J Neurosurg. 2000;92:920-6.
- 9. Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, Speer MC. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery. 1999;44:1005-17.
- 10. Barkovich AJ, Wippold FJ, Sherman JL, Citrin CM. Significance of cerebellar tonsillar position on MR. AJNR Am J Neuroradiol. 1986;7:795-9.
- 11. Ishikawa M, Kikuchi H, Fujisawa I, Yonekawa Y. Tonsillar herniation on magnetic resonance imaging. Neurosurgery. 1988;22:77-81.
- 12. Oakes WJ, Tubbs RS. Chiari malformations. In: Winn HR, editor. Youmans Neurological Surgery. 5th Ed.p.3347–61, 2004.
- 13. Milhorat TH, Bolognese PA, Nishikawa M, McDonnell NB, Francomano CA. Syndrome of occipitoatlantoaxial hypermobility, cranial settling, and chiari malformation type I in patients with hereditary disorders of connective tissue. J Neurosurg Spine. 2007;7:601-9.
- 14. Schady W, Metcalfe RA, Butler P. The incidence of craniocervical bony anomalies in the adult Chiari malformation. J Neurol Sci. 1987;82:193-203. 15. James HE, Brant A. Treatment of the Chiari malformation with bone decompression without durotomy in children and young adults. Childs Nerv Syst. 2002;18:202-6.
- 16. Di Lorenzo N, Cacciola F. Adult syringomielia. Classification, pathogenesis and therapeutic approaches. J Neurosurg Sci. 2005;49:65-72.
- 17. Nishikawa M, Sakamoto H, Hakuba A, Nakanishi N, Inoue Y. Pathogenesis of Chiari malformation: a morphometric study of the posterior cranial fossa. J Neurosurg. 1997;86:40-7.
- 18. Marin-Padilla M, Marin-Padilla TM. Morphogenesis of experimentally induced Arnold-Chiari malformation. J Neurol Sci. 1981;50:29-55.
- 19. Aydin S, Hanimoglu H, Tanriverdi T, Yentur E, Kaynar MY. Chiari type I malformations in adults: a morphometric analysis of the posterior cranial fossa. Surg Neurol. 2005;64:237-41.
- 20. Tubbs RS, Iskandar BJ, Bartolucci AA, Oakes WJ. A critical analysis of the Chiari 1.5 malformation. J Neurosurg. 2004;101:179-83. 21. Noudel R, Jovenin N, Eap C, Scherpereel B, Pierot L, Rousseaux P. Incidence of basioccipital hypoplasia in Chiari malformation type I: comparative morphometric study of the posterior cranial fossa. Clinical article. J Neurosurg. 2009;111:1046-52.
- 22. Hwang HS, Moon JG, Kim CH, Oh SM, Song JH, Jeong JH. The comparative morphometric study of the posterior cranial fossa : what is effective approaches to the treatment of Chiari malformation type 1. J Korean Neurosurg Soc. 2013;54:405-10.
- 23. Vega A, Quintana F, Berciano J. Basichondrocranium anomalies in adult Chiari type I malformation: a morphometric study. J Neurol Sci. 1990;99:137-45. 24. Mikulis DJ, Diaz O, Egglin TK, Sanchez R. Variance of the position of the cerebellar tonsils with age: preliminary report. Radiology. 1992;183:725-8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2022 |
| Kabul Tarihi | 20 Haziran 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 47 Sayı: 3 |
