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Radiological approach to basilar invagination type B: Reliability and accuracy - 23/09/20

Doi : 10.1016/j.neurad.2020.08.005 
Begümhan Baysal , Mehmet Bilgin Eser, Mine Sorkun
 Department of Radiology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, 34722, Turkey 

Corresponding author at: Department of Radiology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, 34722, TurkeyDepartment of Radiology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research HospitalIstanbul34722Turkey
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 23 September 2020

Graphical abstract




Le texte complet de cet article est disponible en PDF.

Highlights

Boogard’s angle have the best diagnostic accuracy for basilar invagination.
Chamberlain line and Boogard’s angle have an excellent inter-rater agreement.
In cases where odontoid apex to the Chamberlain line distance cannot be measured, the best alternative is Boogard's angle.

Le texte complet de cet article est disponible en PDF.

Abstract

Objectives

This study aims to determine the reliability of the radiological tests used in the diagnosis of basilar invagination (BI).

Methods

Patients diagnosed with type B basilar invagination, who had both magnetic resonance (MR) and computed tomography (CT) imaging between January 2014 and November 2019 were included in this retrospective reliability study. In this study, distance from odontoid apex to Chamberlain’s line (OA-CL) was accepted as a reference method for the diagnosis. Forty-two BI cases and 79 controls were included. Three radiologists with different levels of experience individually evaluated OA-CL, Boogard’s angle (BoA), clivo-axial angle (CXA), clivo-dens angle (CDA), and clivo-palate angle (CPA) on midsagittal CT and MR images. Statistical analysis was made with the intraclass correlation coefficient (ICC), t-test, and receiver operating characteristic (ROC) curve.

Results

The ICC for CT and MR were; 0.977−0.973 (OA-CL), 0.912−0.882 (BoA), 0.845−0.846 (CXA), 0.862−0.864 (CDA), and 0.762−0.747 (CPA) respectively (P < 0.001). The areas under the ROC curve were 0.977 (BoA), 0.832 (CXA), 0.852 (CDA), and 0.719 (CPA) (P < 0.001). The cut-off measures were ≥137.84° (BoA), ≤149.25° (CXA), ≤129.58° (CDA), and ≤61.83° (CPA). The diagnostic accuracies were 0.954 (BoA), 0.664 (CXA), 0.704 (CDA), 0.438 (CPA) (P < 0.001).

Conclusions

OA-CL and BoA express excellent inter-rater agreement than CXA, CDA, and CPA, which are limited due to morphological variations and head spatial position. BoA is the second most reliable diagnostic test. CXA, CDA, should only be used for complementary information. CPA was found inadequate for the diagnosis of BI.

Le texte complet de cet article est disponible en PDF.

Keywords : Skull base, Atlanto-occipital joint, Odontoid process, Magnetic resonance imaging, Multidetector computed tomography


Plan


 This study was presented in Turkish Society of Neuroradiology 29th Year Annual Meeting with International Participation Neuroradiology and Head Neck Radiology, February 14–16, 2020, Istanbul, Turkey
☆☆ Abstract of the manuscript was published Neuroradiology journal in February 2020 entitled TSNR 2020 page 263–266.


© 2020  Elsevier Masson SAS. Tous droits réservés.
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