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Patrones de dinámica del LCR en RM para diferenciar malformación de Chiari 1 simple y compleja.

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Title: Patrones de dinámica del LCR en RM para diferenciar malformación de Chiari 1 simple y compleja.
Alternate Title: Cerebrospinal fluid dynamics patterns on MRI to differentiate between simple and complex Chiari 1 malformation.
Authors: Vigliano, Alejandra P.1 avigliano@fleni.org.ar, Sánchez-Solano, Alejandro1, Hernández-Pinzón, Jairo1, Carnevale, Martín1, Chaves, Hernán1, Aguilar, Martín1
Source: Revista Argentina de Radiología. 2026, Vol. 90 Issue 3, p130-138. 9p.
Abstract (English): Introduction: Complex Chiari malformation is a more severe variant of Chiari malformation type 1 (CM1), that requires a different surgical approach. Objective: To evaluate whether cerebrospinal fluid (CSF) dynamics on phase-contrast MRI (PC-MRI) can distinguish between simple (SCM) and complex (CCM) subtypes of CM1. Method: This retrospective study included 25 pediatric patients with CM1 and pre-surgical PC-MRI, who underwent surgery from 2013 to 2021. Three independent evaluators diagnosed CCM and classified CSF dynamics into six patterns based on anterior and/or posterior flow alterations. t-test, x² or Fischer test, and kappa coefficient, were used for analysis. p < 0.05 was considered statistically significant. Results: Eleven patients (44%) met the criteria for CCM. Patterns 0, 1 and 2 were common in SCM (77.7%) and absent in CCM. Patterns 4, 5 and 6 were predominant in CCM (27.3, 9.1 and 63.6%, respectively), versus 7.1% (each) in SCM. Anterior CSF flow blockage was found in 90.9% of CCM patients, compared to 14.3% in SCM (p < 0.001). The interobserver agreement was high (kappa: 0.79-0.92). Conclusions: Anterior circulatory blockage, alone or with posterior blockage, is more frequently observed in CCM. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducció n: La malformació n de Chiari compleja es una variante m á s grave de la malformació n de Chiari tipo 1 (MC1), que requiere un abordaje quirúrgico diferente. Objetivo: Evaluar si la dinámica del l íquido cefalorraquídeo (LCR) en secuen-cia de contraste de fase en resonancia magnética (RM-CF) permite discriminar entre subtipos simple (MCS) y complejo (MCC) de MC1. M étodo: Estudio retrospectivo, de 25 pacientes pediátricos con MC1 y RM-CF prequirúrgica, operados entre 2013 y 2021. Tres evaluadores independientemente diagnosticaron MCC y clasificaron la dinámica del LCR en seis patrones segú n la alteració n anterior, posterior o ambas. Se aplicaron las pruebas t, x² o Fisher, y el coeficiente kappa. Se consideró significativo p <0, 05. Resultados: Once pacientes (44%) presentaron MCC. Los patrones 0, 1 y 2 fueron frecuentes en MCS (77, 7%) y ausentes en MCC. Los patrones 4, 5 y 6 predominaron en MCC (27, 3%, 9, 1% y 63, 6%, respectivamente), frente al 7, 1% (cada uno) en MCS. El 90, 9% de MCC presentó bloqueo anterior del LCR, frente al 14, 3% de MCS (p<0, 001). ΕΙ acuerdo interobservador fue alto (kappa: 0, 79-0, 92). Conclusiones: El bloqueo anterior del flujo del LCR, solo o con bloqueo posterior, es m á s frecuente en la MCC. [ABSTRACT FROM AUTHOR]
Copyright of Revista Argentina de Radiología is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Vigliano%2C+Alejandra+P%2E%22&quot;&gt;Vigliano, Alejandra P.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; avigliano@fleni.org.ar&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22S&#225;nchez-Solano%2C+Alejandro%22&quot;&gt;S&#225;nchez-Solano, Alejandro&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hern&#225;ndez-Pinz&#243;n%2C+Jairo%22&quot;&gt;Hern&#225;ndez-Pinz&#243;n, Jairo&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Carnevale%2C+Mart&#237;n%22&quot;&gt;Carnevale, Mart&#237;n&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Chaves%2C+Hern&#225;n%22&quot;&gt;Chaves, Hern&#225;n&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Aguilar%2C+Mart&#237;n%22&quot;&gt;Aguilar, Mart&#237;n&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;
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– Name: Abstract
  Label: Abstract (English)
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  Data: Introduction: Complex Chiari malformation is a more severe variant of Chiari malformation type 1 (CM1), that requires a different surgical approach. Objective: To evaluate whether cerebrospinal fluid (CSF) dynamics on phase-contrast MRI (PC-MRI) can distinguish between simple (SCM) and complex (CCM) subtypes of CM1. Method: This retrospective study included 25 pediatric patients with CM1 and pre-surgical PC-MRI, who underwent surgery from 2013 to 2021. Three independent evaluators diagnosed CCM and classified CSF dynamics into six patterns based on anterior and/or posterior flow alterations. t-test, x&#178; or Fischer test, and kappa coefficient, were used for analysis. p &lt; 0.05 was considered statistically significant. Results: Eleven patients (44%) met the criteria for CCM. Patterns 0, 1 and 2 were common in SCM (77.7%) and absent in CCM. Patterns 4, 5 and 6 were predominant in CCM (27.3, 9.1 and 63.6%, respectively), versus 7.1% (each) in SCM. Anterior CSF flow blockage was found in 90.9% of CCM patients, compared to 14.3% in SCM (p &lt; 0.001). The interobserver agreement was high (kappa: 0.79-0.92). Conclusions: Anterior circulatory blockage, alone or with posterior blockage, is more frequently observed in CCM. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Introducci&#243; n: La malformaci&#243; n de Chiari compleja es una variante m &#225; s grave de la malformaci&#243; n de Chiari tipo 1 (MC1), que requiere un abordaje quir&#250;rgico diferente. Objetivo: Evaluar si la din&#225;mica del l &#237;quido cefalorraqu&#237;deo (LCR) en secuen-cia de contraste de fase en resonancia magn&#233;tica (RM-CF) permite discriminar entre subtipos simple (MCS) y complejo (MCC) de MC1. M &#233;todo: Estudio retrospectivo, de 25 pacientes pedi&#225;tricos con MC1 y RM-CF prequir&#250;rgica, operados entre 2013 y 2021. Tres evaluadores independientemente diagnosticaron MCC y clasificaron la din&#225;mica del LCR en seis patrones seg&#250; n la alteraci&#243; n anterior, posterior o ambas. Se aplicaron las pruebas t, x&#178; o Fisher, y el coeficiente kappa. Se consider&#243; significativo p &lt;0, 05. Resultados: Once pacientes (44%) presentaron MCC. Los patrones 0, 1 y 2 fueron frecuentes en MCS (77, 7%) y ausentes en MCC. Los patrones 4, 5 y 6 predominaron en MCC (27, 3%, 9, 1% y 63, 6%, respectivamente), frente al 7, 1% (cada uno) en MCS. El 90, 9% de MCC present&#243; bloqueo anterior del LCR, frente al 14, 3% de MCS (p&lt;0, 001). ΕΙ acuerdo interobservador fue alto (kappa: 0, 79-0, 92). Conclusiones: El bloqueo anterior del flujo del LCR, solo o con bloqueo posterior, es m &#225; s frecuente en la MCC. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Revista Argentina de Radiolog&#237;a is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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              Text: 2026
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