Bibliographic Details
| 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] |
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| Database: |
MedicLatina |
