Universität zu Köln

Lawrence, Braden J., Urbizu, Aintzane ORCID: 0000-0001-8458-1209, Allen, Philip A., Loth, Francis, Tubbs, R. Shane, Bunck, Alexander C., Kroeger, Jan-Robert, Rocque, Brandon G., Madura, Casey, Chen, Jason A., Luciano, Mark G., Ellenbogen, Richard G., Oshinski, John N., Iskandar, Bermans J. and Martin, Bryn A. ORCID: 0000-0003-1234-7880 (2018). Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliability. Fluids Barriers CNS, 15. LONDON: BMC. ISSN 2045-8118

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Abstract

BackgroundType 1 Chiari malformation (CM-I) has been historically defined by cerebellar tonsillar position (TP) greater than 3-5mm below the foramen magnum (FM). Often, the radiographic findings are highly variable, which may influence the clinical course and patient outcome. In this study, we evaluate the inter-operator reliability (reproducibility) of MRI-based measurement of TP in CM-I patients and healthy controls.MethodsThirty-three T2-weighted MRI sets were obtained for 23 CM-I patients (11 symptomatic and 12 asymptomatic) and 10 healthy controls. TP inferior to the FM was measured in the mid-sagittal plane by seven expert operators with reference to McRae's line. Overall agreement between the operators was quantified by intraclass correlation coefficient (ICC).ResultsThe mean and standard deviation of cerebellar TP measurements for asymptomatic (CM-Ia) and symptomatic (CM-Is) patients in mid-sagittal plane was 6.382.19 and 9.57 +/- 2.63mm, respectively. TP measurements for healthy controls was 0.48 +/- 2.88mm. The average range of TP measurements for all data sets analyzed was 7.7mm. Overall operator agreement for TP measurements was relatively high with an ICC of 0.83.ConclusionThe results demonstrated a large average range (7.7mm) of measurements among the seven expert operators and support that, if economically feasible, two radiologists should make independent measurements before radiologic diagnosis of CM-I and surgery is contemplated. In the future, an objective diagnostic parameter for CM-I that utilizes automated algorithms and results in smaller inter-operator variation may improve patient selection.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lawrence, Braden J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Urbizu, Aintzane UNSPECIFIED orcid.org/0000-0001-8458-1209 UNSPECIFIED Allen, Philip A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loth, Francis UNSPECIFIED UNSPECIFIED UNSPECIFIED Tubbs, R. Shane UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, Alexander C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Jan-Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Rocque, Brandon G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Madura, Casey UNSPECIFIED UNSPECIFIED UNSPECIFIED Chen, Jason A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Luciano, Mark G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ellenbogen, Richard G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Oshinski, John N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Iskandar, Bermans J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Martin, Bryn A. UNSPECIFIED orcid.org/0000-0003-1234-7880 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-161918
DOI:	10.1186/s12987-018-0118-1
Journal or Publication Title:	Fluids Barriers CNS
Volume:	15
Date:	2018
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	2045-8118
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CEREBROSPINAL-FLUID DYNAMICS; NATURAL-HISTORY; POSTERIOR-FOSSA; DECOMPRESSION; CHILDREN; POSITION; FLOW; RECURRENCE; PULSATIONS; ASYMMETRY Multiple languages Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16191