ArticleFluids and barriers of the CNS2018
Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliability.
Article in Fluids and barriers of the CNS, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Normative cerebellar tonsil position in healthy individuals: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Pooled it
- Cognition in Chiari Malformation Type I: an Update of a Systematic Review.Neuropsychology review · 2024Pooled it
- Chiari malformation type 1 is associated with a smaller fourth ventricle volume - a multi-cohort replication study.Scientific reports · 2026Article
- Morphometric assessment of the posterior cranial fossa and its contents in patients with chiari malformation type I and type 0.Acta neurochirurgica · 2026Article
- Surgical Outcomes in Chiari 1 and Chiari 1.5 Malformation Treated by Posterior Fossa Reconstruction: A Comprehensive Analysis of 110 Pediatric Cases and Literature Review.Journal of clinical medicine · 2024Article
- Article
- A genetic component in Chiari I malformation: Chiari 1 malformation in all five family members.Radiology case reports · 2024Article
- Evaluation and Treatment of Patients with Small Posterior Cranial Fossa and Chiari Malformation, Types 0 and 1.Advances and technical standards in neurosurgery · 2024Article
- Geometric morphometric analysis of the brainstem and cerebellum in Chiari I malformation.Frontiers in neuroanatomy · 2024Article
- A Critical Update of the Classification of Chiari and Chiari-like Malformations.Journal of clinical medicine · 2023Review
- Headache characteristics and postoperative course in Chiari I malformation.Cephalalgia : an international journal of headache · 2022Article
- Use of deep learning in the MRI diagnosis of Chiari malformation type I.Neuroradiology · 2022Article
- Diagnostic utility of parasagittal measurements of tonsillar herniation in Chiari I malformation.The neuroradiology journal · 2022Article
- Is there a morphometric cause of Chiari malformation type I? Analysis of existing literature.Neurosurgical review · 2022Review
- Chiari 1 malformation and exome sequencing in 51 trios: the emerging role of rare missense variants in chromatin-remodeling genes.Human genetics · 2021Article
- Article
- Correlation of a new hydrodynamic index with other effective indexes in Chiari I malformation patients with different associations.Scientific reports · 2020Article
- Clinical utility of 2-D anatomic measurements in predicting cough-associated headache in Chiari I malformation.Neuroradiology · 2020Article
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15 authors at 12 institutions in 2 countries.
Funding
Abstract
backgroundType 1 Chiari malformation (CM-I) has been historically defined by cerebellar tonsillar position (TP) greater than 3-5 mm below the foramen magnum (FM). Often, the radiographic findings are highly variable, which may influence the clinical course and patient outcome. In this study, we evaluate the inter-operator reliability (reproducibility) of MRI-based measurement of TP in CM-I patients and healthy controls.
methodsThirty-three T2-weighted MRI sets were obtained for 23 CM-I patients (11 symptomatic and 12 asymptomatic) and 10 healthy controls. TP inferior to the FM was measured in the mid-sagittal plane by seven expert operators with reference to McRae's line. Overall agreement between the operators was quantified by intraclass correlation coefficient (ICC).
resultsThe mean and standard deviation of cerebellar TP measurements for asymptomatic (CM-Ia) and symptomatic (CM-Is) patients in mid-sagittal plane was 6.38 ± 2.19 and 9.57 ± 2.63 mm, respectively. TP measurements for healthy controls was 0.48 ± 2.88 mm. The average range of TP measurements for all data sets analyzed was 7.7 mm. Overall operator agreement for TP measurements was relatively high with an ICC of 0.83.
conclusionThe results demonstrated a large average range (7.7 mm) of measurements among the seven expert operators and support that, if economically feasible, two radiologists should make independent measurements before radiologic diagnosis of CM-I and surgery is contemplated. In the future, an objective diagnostic parameter for CM-I that utilizes automated algorithms and results in smaller inter-operator variation may improve patient selection.
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