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

Abstract

To examine the spinal cord status by using diffusion tensor imagıng (DTI) and tractography preoperatively and postoperatively in patients with Chiari malformation type 1 (CM1) and compare the results with the data obtained from healthy people. Overall, 48 patients (33 patients with CM1, and 15 in the control group for DTI and tractography measurements) were included in the study. Mean age was 37.7 ± 11.8 years (minimum and maximum: 12 and 57 years). The DTI and tractography data were obtained from the craniocervical region in patients with CM1 and control group. Patients with CM1 were operated using the suboccipital decompression technique without opening the dura. Surgical results were evaluated using Chicago Chiari Outcome Scale (CCOS) and Asgari scale. Based on the CCOS and Asgari scale results, the surgical technique was determined to be clinically beneficial. The DTI and tractography values from the pontobulbar, cervicomedullary, and spinal cord C3â€"4 levels in patients with CM1 were compared to those of the control group. These values were observed to be near normal after surgery in patients with CM1. Based on the improvement in DTI-tractography data observed in our study, DTI and tractography can serve as a guiding measurement method for assessing the prognosis of patients with CM1.