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Investigating Type B Basilar Invagination Through Cephalic Indices.

José J C Nascimento1, Leandro M Silva1, Elayne C O Ribeiro2

  • 1Postgraduate Program in Neuropsychiatry, Federal University of Pernambuco, Recife, Brazil.

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|June 10, 2022
PubMed
Summary

The height/width index (HWI) is a more accurate diagnostic tool for type B basilar invagination (BI) than the width/length index (WLI). HWI offers robust sensitivity and specificity for identifying this condition.

Keywords:
CephalometryOdontoid processSensitivity and specificitySkull

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Area of Science:

  • Neurosurgery
  • Radiology
  • Medical Imaging

Background:

  • Basilar invagination (BI) is a complex condition affecting the craniocervical junction.
  • Accurate diagnosis of type B basilar invagination is crucial for effective management.

Purpose of the Study:

  • To compare the diagnostic accuracy of cephalic indices, specifically the width/length index (WLI) and height/width index (HWI), for type B basilar invagination (BI).

Main Methods:

  • Retrospective analysis of head and neck MRI scans from 31 type B BI cases and 96 controls.
  • Two blinded examiners measured cephalic indices (WLI and HWI), odontoid process to Chamberlain line distance, and clivus canal angle.
  • Reproducibility assessed by intraclass correlation coefficient; diagnostic accuracy determined by receiver operating characteristic (ROC) curve analysis.

Main Results:

  • Cephalic indices demonstrated high inter- and intra-examiner reproducibility (≥94%).
  • The HWI showed a significantly larger area under the ROC curve (0.874) compared to WLI (0.639).
  • HWI achieved a sensitivity of 74.7% and specificity of 85.5% for type B BI detection.

Conclusions:

  • The height/width index (HWI) exhibits superior diagnostic performance for type B basilar invagination compared to the width/length index (WLI).
  • Cranial height and width proportions, as measured by HWI, are valuable for clinicians investigating type B BI.