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Basion-Cartilaginous Dens Interval: An Imaging Parameter for Craniovertebral Junction Assessment in Children
A K Singh1, Z Fulton2, R Tiwari2
1From the Department of Radiology, University of Texas Health Science Center San Antonio, San Antonio, Texas. singhak@uthscsa.edu.
Insights
The basion-cartilaginous dens interval, a new measure for craniovertebral junction integrity in children, shows age-dependent normal values. This parameter includes cartilage, offering a more comprehensive assessment than bony measurements alone.
Area of Science:
- Pediatric Radiology
- Orthopedic Imaging
- Craniovertebral Junction Anatomy
Background:
- Widening of the basion-dens interval indicates craniovertebral junction injury.
- Existing literature on pediatric basion-dens interval values is limited and based on bony measurements.
- A novel imaging parameter, the basion-cartilaginous dens interval, has been described.
Purpose of the Study:
- To establish normal values for the basion-cartilaginous dens interval in children.
- To assess the utility of this new parameter in evaluating craniovertebral junction integrity.
- To compare values across different pediatric age groups.
Main Methods:
- Retrospective analysis of 300 healthy pediatric patients (0-10 years).
- Patients categorized into three age groups: 0-3, 3-6, and 6-10 years.
- Basion-cartilaginous dens interval measured on sagittal cervical spine CT in a soft-tissue window.
Main Results:
- Upper limits of the basion-cartilaginous dens interval were 5.34 mm (0-3 yrs), 5.64 mm (3-6 yrs), and 7.24 mm (6-10 yrs).
- Statistically significant differences in interval values were observed among the three age groups.
- No significant difference found between sexes, but group C (6-10 yrs) differed significantly from groups A and B.
Conclusions:
- The basion-cartilaginous dens interval is a novel imaging parameter for assessing pediatric craniovertebral junction integrity.
- This measurement incorporates nonossified cartilage, providing a more complete assessment.
- Normal values vary significantly with age in children.
Background And Purpose:
Widening of the basion-dens interval is an important sign of cranioverterbral junction injury. The current literature on basion-dens interval in children is sparse and based on bony measurements with variable values. Our goal was to establish the normal values of a recently described new imaging parameter, the basion-cartilaginous dens interval in children.
Materials And Methods:
Three hundred healthy pediatric patients (0-10 years of age) were selected retrospectively. These patients were divided into 3 different groups: A (0-3 years), B (3-6 years), and C (6-10 years). The basion-cartilaginous dens interval was calculated on the sagittal MPR image of cervical spine CT in a soft-tissue window. The mean, SD, and the upper limit of normal (mean +2 SDs) of the 3 groups were calculated, and statistical tests were used to check for significant differences of the basion-cartilaginous dens interval among these 3 groups.
Results:
The upper limits of the basion-cartilaginous dens interval for the 3 groups were 5.34 mm in group A, 5.64 mm in group B, and 7.24 mm in group C. There were statistically significant differences in the basion-cartilaginous dens interval values among the 3 groups. There was no statistically significant difference in basion-cartilaginous dens interval values between groups A and B; however, values in group C were significantly different from those in both A and B. There was no statistically significant difference in the basion-cartilaginous dens interval values between males and females.
Conclusions:
The basion-cartilaginous dens interval is a novel imaging parameter to assess cranioverterbral junction integrity in children, which includes the nonossified cartilage in the measurement.
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