Journal article
Analysis and interrater reliability of pB-C2 using MRI and CT: data from the Park-Reeves Syringomyelia Research Consortium on behalf of the Pediatric Craniocervical Society
Journal of neurosurgery. Pediatrics, Vol.20(2), pp.170-175
08/2017
DOI: 10.3171/2017.3.PEDS16604
PMID: 28524792
Abstract
OBJECTIVE The distance to the ventral dura, perpendicular to the basion to C2 line (pB-C2), is commonly employed as a measure describing the anatomy of the craniovertebral junction. However, both the reliability among observers and the clinical utility of this measurement in the context of Chiari malformation Type I (CM-I) have been incompletely determined. METHODS Data were reviewed from the first 600 patients enrolled in the Park-Reeves Syringomyelia Research Consortium with CM-I and syringomyelia. Thirty-one cases were identified in which both CT and MRI studies were available for review. Three pediatric neurosurgeons independently determined pB-C2 values using common imaging sequences: MRI (T1-weighted and T2-weighted with and without the inclusion of retro-odontoid soft tissue) and CT. Values were compared and intraclass correlations were calculated among imaging modalities and observers. RESULTS Intraclass correlation of pB-C2 demonstrated strong agreement between observers (intraclass correlation coefficient [ICC] range 0.72-0.76). Measurement using T2-weighted MRI with the inclusion of retro-odontoid soft tissue showed no significant difference with measurement using T1-weighted MRI. Measurements using CT or T2-weighted MRI without retro-odontoid soft tissue differed by 1.6 mm (4.69 and 3.09 mm, respectively, p < 0.05) and were significantly shorter than those using the other 2 sequences. Conclusions pB-C2 can be measured reliably by multiple observers in the context of pediatric CM-I with syringomeyelia. Measurement using T2-weighted MRI excluding retro-odontoid soft tissue closely approximates the value obtained using CT, which may allow for the less frequent use of CT in this patient population. Measurement using T2-weighted MRI including retro-odontoid soft tissue or using T1-weighted MRI yields a more complete assessment of the extent of ventral brainstem compression, but its association with clinical outcomes requires further study.
Details
- Title: Subtitle
- Analysis and interrater reliability of pB-C2 using MRI and CT: data from the Park-Reeves Syringomyelia Research Consortium on behalf of the Pediatric Craniocervical Society
- Creators
- Todd C Hankinson - Department of Neurosurgery, University of Colorado School of Medicine, Aurora, ColoradoGerald F Tuite - Division of Pediatric Neurosurgery, Neuroscience Institute, Johns Hopkins All Children's Hospital, St. Petersburg, FloridaDagmara I Moscoso - Department of Neurosurgery, Columbia University, Morgan Stanley Children's Hospital of NewYork-Presbyterian, New York, New YorkLeslie C Robinson - Department of Neurosurgery, University of Colorado School of Medicine, Aurora, ColoradoJames C Torner - University of Iowa College of Public Health, Iowa City, Iowa; andDavid D Limbrick Jr - Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, MissouriTae Sung Park - Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, MissouriRichard C E Anderson - Department of Neurosurgery, Columbia University, Morgan Stanley Children's Hospital of NewYork-Presbyterian, New York, New YorkPark-Reeves Syringomyelia Research Consortium
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery. Pediatrics, Vol.20(2), pp.170-175
- DOI
- 10.3171/2017.3.PEDS16604
- PMID
- 28524792
- NLM abbreviation
- J Neurosurg Pediatr
- ISSN
- 1933-0715
- eISSN
- 1933-0715
- Publisher
- United States
- Language
- English
- Date published
- 08/2017
- Academic Unit
- Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983996061002771
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