Morphology of the inferior border of cerebellar to
Professor Li Detai et al of the department of radiology, the second Xiangya hospital, Southern central University, discovered in their control study with MRI for patients with Chiari's malformation type I (CMI) and normal person that the morphology and position of the lower border of cerebellar tonsil were of importance value for the diagnsis of CMI.
The chief pathological feature of CMI is the herniation of cerebral tonsil into the vertebral canal, and may associate with downward displacement of the medulla oblongata and the fourth cerebral ventricle, with the onset usually during the late period of childhood or the adulthood. Owing to its congenital factor of the episode and the secondary acquired changes, the clinical manifestation turned out to be complicated giving difficulties in diagnosis. In the diagnosis and evaluation of CMI, MRI examination played a key role. For the establishment of the diagnostic standard, the researchers conducted a measurement analysis of the MRI of cerebral tonsil in 20 cases of clinically diagnosed CMI (the patient group) and that in 178 normal persons (age ranged from 9 months to 81 years with the disorders causing displacement of the cerebral tonsil ruled out).
The results revealed that in the normal persons the lower border of the cerebral tonsil assumed a round shape and among the patients with CMI, 18 (90 %) the lower border of the cerebral tonsil assumed an apiciform, and 2 cases (10 %) had the circular configuration; there was significant difference between the two groups (P<0.001). The average distance between the lower border of the cerebral tonsil and the foramen magnum (expressed with h) was in average 1.9±1.8 mm (2.4~6.7 mm), while in the patient's group the distance was 11.7±1.5 mm (27.5~3.7 mm). The h values of the age groups of patients and the normal persons were significantly different (P<0.05). The researchers concluded that the morphology and location of the lower border of the cerebral tonsil were of important value for the diagnosis of
CMI., http://www.100md.com
The chief pathological feature of CMI is the herniation of cerebral tonsil into the vertebral canal, and may associate with downward displacement of the medulla oblongata and the fourth cerebral ventricle, with the onset usually during the late period of childhood or the adulthood. Owing to its congenital factor of the episode and the secondary acquired changes, the clinical manifestation turned out to be complicated giving difficulties in diagnosis. In the diagnosis and evaluation of CMI, MRI examination played a key role. For the establishment of the diagnostic standard, the researchers conducted a measurement analysis of the MRI of cerebral tonsil in 20 cases of clinically diagnosed CMI (the patient group) and that in 178 normal persons (age ranged from 9 months to 81 years with the disorders causing displacement of the cerebral tonsil ruled out).
The results revealed that in the normal persons the lower border of the cerebral tonsil assumed a round shape and among the patients with CMI, 18 (90 %) the lower border of the cerebral tonsil assumed an apiciform, and 2 cases (10 %) had the circular configuration; there was significant difference between the two groups (P<0.001). The average distance between the lower border of the cerebral tonsil and the foramen magnum (expressed with h) was in average 1.9±1.8 mm (2.4~6.7 mm), while in the patient's group the distance was 11.7±1.5 mm (27.5~3.7 mm). The h values of the age groups of patients and the normal persons were significantly different (P<0.05). The researchers concluded that the morphology and location of the lower border of the cerebral tonsil were of important value for the diagnosis of
CMI., http://www.100md.com