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Multidetector Computed Tomography and Magnetic Resonance Imaging Evaluation of Craniovertebral junction Abnormalities.

Dhadve RU, Garge SS, Vyas PD, Thakker NR, Shah SH, Jaggi ST, Talwar IA - N Am J Med Sci (2015)

Bottom Line: Their precise diagnosis, identification of probable etiology, and pretreatment evaluation significantly affects prognosis and quality of life of patients.Most common age group was 2(nd) -3(rd) decade (19 patients, 30.64%).Developmental anomalies (33 patients, 53.22%) were the most common etiology group followed by traumatic (10 patients, 16.12%), degenerative (eight patients, 12.90%), infective (four patients, 6.45%), inflammatory and neoplastic (three patients each, 4.8%), and no cause found in one patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India.

ABSTRACT

Background: Craniovertebral junction (CVJ) abnormalities constitute an important group of treatable neurological disorders with diagnostic dilemma. Their precise diagnosis, identification of probable etiology, and pretreatment evaluation significantly affects prognosis and quality of life of patients.

Aims: The study was to classify various craniovertebral junction disorders according to their etiology and to define the importance of precise diagnosis for pretreatment evaluation with multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI).

Materials and methods: This is a prospective observational study of 62 patients referred to our department between October 2012 and September 2014. All patients suspected to have a craniovertebral junction disorder were included in the study, from all age groups and both genders. Detailed clinical history was taken. Radiographs of cervical spine were collected if available. All patients were subjected to MDCT and/or MRI.

Results: In our study of 62 patients; 39 were males and 23 were females, with male to female ratio of 1.6:1. Most common age group was 2(nd) -3(rd) decade (19 patients, 30.64%). Developmental anomalies (33 patients, 53.22%) were the most common etiology group followed by traumatic (10 patients, 16.12%), degenerative (eight patients, 12.90%), infective (four patients, 6.45%), inflammatory and neoplastic (three patients each, 4.8%), and no cause found in one patient.

Conclusions: CVJ abnormalities constitute an important group of treatable neurological disorders, especially in certain ethnic groups and are approached with much caution by clinicians. Thus, it is essential that radiologists should be able to make a precise diagnosis of craniovertebral junction abnormalities, classify them into etiological group, and rule out important mimickers on MDCT and/or MRI, as this information ultimately helps determine the management of such abnormalities, prognosis, and quality of life of patients.

No MeSH data available.


Related in: MedlinePlus

CT CVJ region bone window images. (a) Sagittal reconstruction showing reduced anterior atlantodental interval on extension. (b) Coronal reconstruction showing proper alignment of lateral atlantoaxial joints. This is suggestive of reducible atlantoaxial instability. 1 = flexion, 2 = neutral, 3 = extension of neck
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Figure 1: CT CVJ region bone window images. (a) Sagittal reconstruction showing reduced anterior atlantodental interval on extension. (b) Coronal reconstruction showing proper alignment of lateral atlantoaxial joints. This is suggestive of reducible atlantoaxial instability. 1 = flexion, 2 = neutral, 3 = extension of neck

Mentions: Among the developmental anomalies, congenital atlantoaxial dislocation (AAD; 56.45%) [Figure 1a and b], basilar invagination (37.10%) [Figure 2], and occipitalization of atlas (20%) were the common radiological features and often exist with each other in varying combinations. Other developmental anomalies were os odontoideum (nine patients, 14.51%), Chiari malformation (eight patients, 12.90%) [Figure 3], platybasia (five patients, 8.06%), Klippel-Feil syndrome, and unassimilated rudimentary atlas (one patient each, 1.61%).


Multidetector Computed Tomography and Magnetic Resonance Imaging Evaluation of Craniovertebral junction Abnormalities.

Dhadve RU, Garge SS, Vyas PD, Thakker NR, Shah SH, Jaggi ST, Talwar IA - N Am J Med Sci (2015)

CT CVJ region bone window images. (a) Sagittal reconstruction showing reduced anterior atlantodental interval on extension. (b) Coronal reconstruction showing proper alignment of lateral atlantoaxial joints. This is suggestive of reducible atlantoaxial instability. 1 = flexion, 2 = neutral, 3 = extension of neck
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4561442&req=5

Figure 1: CT CVJ region bone window images. (a) Sagittal reconstruction showing reduced anterior atlantodental interval on extension. (b) Coronal reconstruction showing proper alignment of lateral atlantoaxial joints. This is suggestive of reducible atlantoaxial instability. 1 = flexion, 2 = neutral, 3 = extension of neck
Mentions: Among the developmental anomalies, congenital atlantoaxial dislocation (AAD; 56.45%) [Figure 1a and b], basilar invagination (37.10%) [Figure 2], and occipitalization of atlas (20%) were the common radiological features and often exist with each other in varying combinations. Other developmental anomalies were os odontoideum (nine patients, 14.51%), Chiari malformation (eight patients, 12.90%) [Figure 3], platybasia (five patients, 8.06%), Klippel-Feil syndrome, and unassimilated rudimentary atlas (one patient each, 1.61%).

Bottom Line: Their precise diagnosis, identification of probable etiology, and pretreatment evaluation significantly affects prognosis and quality of life of patients.Most common age group was 2(nd) -3(rd) decade (19 patients, 30.64%).Developmental anomalies (33 patients, 53.22%) were the most common etiology group followed by traumatic (10 patients, 16.12%), degenerative (eight patients, 12.90%), infective (four patients, 6.45%), inflammatory and neoplastic (three patients each, 4.8%), and no cause found in one patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India.

ABSTRACT

Background: Craniovertebral junction (CVJ) abnormalities constitute an important group of treatable neurological disorders with diagnostic dilemma. Their precise diagnosis, identification of probable etiology, and pretreatment evaluation significantly affects prognosis and quality of life of patients.

Aims: The study was to classify various craniovertebral junction disorders according to their etiology and to define the importance of precise diagnosis for pretreatment evaluation with multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI).

Materials and methods: This is a prospective observational study of 62 patients referred to our department between October 2012 and September 2014. All patients suspected to have a craniovertebral junction disorder were included in the study, from all age groups and both genders. Detailed clinical history was taken. Radiographs of cervical spine were collected if available. All patients were subjected to MDCT and/or MRI.

Results: In our study of 62 patients; 39 were males and 23 were females, with male to female ratio of 1.6:1. Most common age group was 2(nd) -3(rd) decade (19 patients, 30.64%). Developmental anomalies (33 patients, 53.22%) were the most common etiology group followed by traumatic (10 patients, 16.12%), degenerative (eight patients, 12.90%), infective (four patients, 6.45%), inflammatory and neoplastic (three patients each, 4.8%), and no cause found in one patient.

Conclusions: CVJ abnormalities constitute an important group of treatable neurological disorders, especially in certain ethnic groups and are approached with much caution by clinicians. Thus, it is essential that radiologists should be able to make a precise diagnosis of craniovertebral junction abnormalities, classify them into etiological group, and rule out important mimickers on MDCT and/or MRI, as this information ultimately helps determine the management of such abnormalities, prognosis, and quality of life of patients.

No MeSH data available.


Related in: MedlinePlus