Correlation Research About The Cerebellar Volume And Posterior Fossa Volume Of Chiari Malformation Patients

Background and objective:Chiari Malformation is a common congenital dysplasia.The cause of disease is thought to be due to abnormal embryonic development that the lower part of cerebellar tonsillar dropped to below the foramen magnum,cervical vertebra tube,severe cases under the lower part of the medulla oblongata,and fourth ventricle subordinate vermis and herniation into the spinal canaLIn the definition of CM,treatment or no consensus on the causes.Surgery is the only effective treatment.But the current lack of diagnostic criteria on the objectivity and accuracy of surgical disorders,and further affects the operation effect and symptoms.So,just simple posterior fossa decompression or open the dura mater,posterior fossa decompression of osseous decompression to what extent and whether HT should be cut have no certain standards.So,the purpose of this study is mainly using the computer 3 D reconstruction technology of CM patients and normal cerebellar or on the neck of nuclear MRI data to calculation and statistic analysis,to explore the cerebellum of CM patients and normal person and the relationship between the volume and area of posterior fossa,because the median sagittal images can clearly positioning,and the most representative in the patients with CM,so in the median sagittal images of the area of the cerebellum and posterior fossa to compare.Measurement including the CV,PFV,CA,PFA,HTL,HTV,in order to in patients with CM-I a reliable basis for pathogenesis,diagnosis and treatment.Methods:1.Data collection:Collectionof general hospital of nanjing military region neurosurgery spinal cord center from January 2015 to October 2015 were complete data of 18 patients with CM-I,all are adults,aged between 28 to 70.The collected cases ruled out:always exist secondary disease,nervous system diseases,and cerebellum of active system disease patients.Control group for the same period on the cerebellum or come to our hospital patients with cervical spine MRI,all are adults,aged between 37 to 69,the inclusion criteria for:no secondary disease,nervous system diseases,and cerebellum of active system disease.A total of 30 cases into the control group.2.Data processing:Using Able Software companies in the United States the development of a commodity and drug administration(FDA)certification by the us medical system of three-dimensional graphics modeling 3 D-Doctor 4.0 Software for image segmentation,CM group and the control group first divided into separate view image,and then in turn into the imaging data of the patient,using the Software of automatic function of stroke,trace each patients with cerebellar,calculated according to the scope of the posterior fossa of posterior fossa boundaries,the scope of the posterior fossa is:in the MRI T2 as the median sagittal images,from the slope to the foramen magnum,attachment to the occpital,to top the tentorium,including the brain stem and the scope of the medulla oblongata.CM group also need to measure the hernia out the length of the cerebellum(median sagittal images of foramen magnum below attachment)and automatic hemiation cerebellar stroke,stroke is finished,then the input of each patient MRI layer spacing and the window size,and then three-dimensional reconstruction,to each patient's CV,PFV and HTV value.As for the median sagittal images of the CA,PFA,also with the above method,but reconstruction model of surface area,from input layer 1,can be obtained.3.Statistical analysis:Use SPSS 21.0 software for data analysis,the measurement data to mean +/-standard deviation,according to comparison between the two groups using independent sample t test,P<0.05 judgement for the difference was statistically significant Using GraphPad Prism 5 software to CV/PFV and median sagittal images of CA/PFA,HTL and HTV dot statistics,and explore its correlation.Results:No significant difference between men and women's age,CV and PFV ratio,CA and PFA ratio,HTL and HTV.C V value from 27.97cm to 214.37 cm,PFV values is from 38.55 cm to 38.55 cm,but the CM group's total CV and PFV ratio was 73.68±7.23%,control group's total CV and PFV ratio was 65.04±5.70%,CV and PFV ratio in the CM group is bigger than control group(P<0.005);And CM group total CA and PFA ratio was 60.43 ±4.36%,control group total C A and PFA ratio was 46.07 ± 2.25%,the ratio of CA and PFA of CM group is also bigger than the control group(P<0.005).And CV and PFV ratio in CM group and control group with the median sagittal images of CV and PFV ratio,HTL and HTV between dot figure are positively linear correlation.Conclusion:the patients with CM-I CV and PFV ratio and median sagittal CA and PFA ratio is normal,and posterior fossa volume is relatively small,content and volumetric proportion of aberrant.Between CV and PFV ratio with CA and PFA ratio,HTL and HTV was positively linear correlation,that the median sagittal images of CA and PFA ratio indirectly,to a certain extent reflects the value of the CV and PFV ratio,and HTL to a certain extent,also indirectly reflects the value of HTV.Thus according to CM-I median sagittal images of patients with C A and PFA ratio,the value of the HTL can assess CV and PFV ratio and HTV value,which can more accurately evaluate patients with CM posterior fossa contents and degree of disorders of the volume ratio,namely the median sagittal images of CA and PFA ratio is smaller,the greater the value of HTL,contents of posterior fossa of CM and the volume ratio of the disorder.To the research in the pathogenesis of Chiari malformation,and the patient's diagnosis,and provide reliable evidence for the selection of surgical procedure.