Clivus height value: a new diagnostic method for basilar invagination at CT.

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Clivus height value: a new diagnostic method for basilar invagination at CT.

Clin Radiol. 2016 Nov;71(11):1200.e1-5

Authors: Xu S, Gong R

Abstract
AIM: To investigate whether clivus height (CH; the distance of the basion above Chamberlain's line) could be used to diagnose basilar invagination (BI) at computed tomography (CT).
MATERIALS AND METHODS: This retrospective study received institutional review board approval, and was performed from 1 January 2013, to 1 July 2015 with a waiver of informed consent. CH was measured on mid-sagittal reconstructed CT images from 65 BI patients and 85 control subjects to compare the two groups by using the independent-samples t-test. Inter- and intra-observer reliability were evaluated with the intraclass correlation coefficient (ICC). To evaluate the diagnostic performance and determine the cut-off value of CH, receiver operating characteristic (ROC) curves were utilised.
RESULTS: The measurement of CH showed good inter- and intra-observer agreement (ICC=0.96 and 0.98, respectively). Compared with control subjects whose mean CH value was 0.35±0.29 cm (range, -0.18 to 1.2 cm), BI patients had a significantly (p<0.001) larger CH, 1.2±0.55 cm (range, 0.43-3.2 cm). The area under the ROC curve was 0.949 (95% confidence interval: 0.916, 0.982), and based on the cut-off value of 0.65 cm, the sensitivity, specificity, positive predictive value, and negative predictive value were 0.88 (57/65), 0.88 (75/85), 0.85 (57/67), and 0.91 (75/82), respectively.
CONCLUSION: Although not better than CL (the distance of the odontoid tip above Chamberlain's line), measurement of CH at CT is reproducible and can diagnose patients with BI.

PMID: 27177855 [PubMed - indexed for MEDLINE]

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