Prognostic Value of Craniovertebral Junction Diffusion Tensor Imaging in Patients with Chiari Type 1 Malformation

Özet

AIM: To examine the spinal cord status by using diffusion tensor imagıng (DTI) and tractography preoperatively and postoperativelyin patients with Chiari malformation type 1 (CM1) and compare the results with the data obtained from healthy people.MATERIAL and METHODS: Overall, 48 patients (33 patients with CM1, and 15 in the control group for DTI and tractographymeasurements) were included in the study. Mean age was 37.7 ± 11.8 years (minimum and maximum: 12 and 57 years). The DTIand tractography data were obtained from the craniocervical region in patients with CM1 and control group. Patients with CM1 wereoperated using the suboccipital decompression technique without opening the dura. Surgical results were evaluated using ChicagoChiari Outcome Scale (CCOS) and Asgari scale.RESULTS: Based on the CCOS and Asgari scale results, the surgical technique was determined to be clinically beneficial. The DTIand tractography values from the pontobulbar, cervicomedullary, and spinal cord C3–4 levels in patients with CM1 were comparedto those of the control group. These values were observed to be near normal after surgery in patients with CM1.CONCLUSION: Based on the improvement in DTI-tractography data observed in our study, DTI and tractography can serve as aguiding measurement method for assessing the prognosis of patients with CM1.