Dynamic cerebellar herniation in Chiari patients during the cardiac cycle evaluated by dynamic magnetic resonance imaging

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  • M. Tietze, Charite - Universitatsmedizin Berlin
  • ,
  • A. Schaumann, Charite - Universitatsmedizin Berlin
  • ,
  • U. Thomale, Charite - Universitatsmedizin Berlin
  • ,
  • Ph Hofmann
  • A. Tietze

Purpose: Cerebellar herniation in Chiari patients can be dynamic, following the cerebrospinal fluid pulsatility during the cardiac cycle. We present a voxel intensity distribution method (VIDM) to automatically extract the pulsatility-dependent herniation in time-resolved MRI (CINE MRI) and compare it to the simple linear measurements. The degree of herniation is furthermore compared on CINE and static sequences, and the cerebellar movement is correlated to the presence of hydrocephalus and syringomyelia. Methods: The cerebellar movement in 27 Chiari patients is analyzed with VIDM and the results were compared to linear measurements on an image viewer (visual inspection, VI) using a paired t test. Second, an ANOVA test is applied to compare the degree of herniation on static 3D MRI and CINE. Finally, the Pearson’s correlation coefficient is calculated for the correlation between cerebellar movement and the presence of hydrocephalus and syringomyelia. Results: VIDM showed significant movement in 85% of our patients. Assuming that movement < 1 mm cannot be detected reliably on an image viewer, VI identified movement in 29.6% of the patients (p = 0.002). The herniation was greater on static sequences than on CINE in most cases, but this was not statistically significant. The cerebellar movement was not correlated with hydrocephalus or syringomyelia (Pearson’s coefficient < 0.3). Conclusions: VIDM is a sensitive method to detect tissue movement on CINE MRI and could be used for Chiari patients, but also for the evaluation of cyst membranes, ventriculostomies, etc. The cerebellar movement appears not to correlate with hydrocephalus and syringomyelia in Chiari patients.

Original languageEnglish
JournalNeuroradiology
Volume61
Issue7
Pages (from-to)825-832
Number of pages8
ISSN0028-3940
DOIs
Publication statusPublished - Jul 2019

    Research areas

  • Balanced steady-state gradient echo MRI, Chiari malformations, Pulsatility-dependent cerebellar herniation

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