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

Area of Science:

• Radiology
• Neurosurgery
• Orthopedics

Background:

• Basilar invagination (BI) is a condition where the upper part of the cervical spine protrudes into the base of the skull.
• Accurate diagnosis of BI is crucial for appropriate management and treatment planning.
• Computed tomography (CT) is a key imaging modality for evaluating craniovertebral junction abnormalities.

Purpose of the Study:

• To evaluate the utility of clivus height (CH) measurement on CT scans for diagnosing basilar invagination (BI).
• To assess the reproducibility and diagnostic performance of CH in differentiating BI patients from healthy controls.

Main Methods:

• A retrospective study involving 65 BI patients and 85 control subjects.
• Clivus height (CH) was measured on mid-sagittal reconstructed CT images.
• Statistical analysis included independent-samples t-test, intraclass correlation coefficient (ICC) for reliability, and ROC curve analysis for diagnostic performance.

Main Results:

• CH measurements demonstrated excellent inter-observer (ICC=0.96) and intra-observer (ICC=0.98) reliability.
• BI patients exhibited significantly greater CH (1.2±0.55 cm) compared to controls (0.35±0.29 cm; p<0.001).
• ROC analysis yielded an area under the curve of 0.949, with a cut-off value of 0.65 cm providing 88% sensitivity and 88% specificity.

Conclusions:

• Measurement of clivus height (CH) on CT is a reproducible method for diagnosing basilar invagination (BI).
• CH measurement demonstrates good diagnostic performance, comparable to other established methods like CL.
• This CT-based measurement provides a valuable tool for identifying patients with BI.