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• Clinical Article •
Study on the evaluation of cervical medullary compression and activity in craniovertebral junction malformation used dynamic flexion-extension cervical spine MRI
FANG Xiongyi  ZENG Wei  PU Yongliang  YANG Haitao 

Cite this article as: FANG X Y, ZENG W, PU Y L, et al. Study on the evaluation of cervical medullary compression and activity in craniovertebral junction malformation used dynamic flexion-extension cervical spine MRI[J]. Chin J Magn Reson Imaging, 2025, 16(6): 110-115, 121. DOI:10.12015/issn.1674-8034.2025.06.016.


[Abstract] Objective To investigate the value of cervical medullary compression and activity in adults with simple and complex Chiari malformation by dynamic flexion-extension cervical spine MRI.Materials and Methods Retrospective collection of clinical data and preoperative cervical CT images and flexion and extension MRI images of 59 patients with Chiari malformation diagnosed clinically and radiologically in our hospital from September 2022 to July 2024. Based on the presence or absence of skull base depression, Chiari malformation was divided into a simple Chiari malformation group (n = 32) and a complex Chiari malformation group (n = 27), with 30 subjects without craniocervical junction malformation as the control group. Measure the cervical medullary angle (CMA) and length of syringomyelia in the mid sagittal plane of cervical dynamic MRI T2WI, and calculate the difference in CMA to obtain the range of cervical medullary activity. Measure the length of cerebellar tonsillar hernia in the mid sagittal plane on T1WI. Paired sample t-test was used to analyze the differences in the CMA of flexion and extension in each group. Using one-way ANOVA and Tukey's HSD pairwise comparison to explore the correlation between the CMA and its difference in flexion and extension positions among the three groups. Mann Whitney U test was used to compare the differences in cerebellar tonsillar hernia length and length of syringomyelia between simple Chiari malformation and complex Chiari malformation.Results The complex Chiari malformation group showed a significant reduction in the CMA on flexion and extension MRI compared to the simple Chiari malformation group and the control group, and the difference was statistically significant (P < 0.001). No statistically significant difference was found between the simple Chiari malformation group and the control group (P = 0.323). There was no statistically significant difference in the activity of the cervical medulla oblongata among the three groups (P = 0.699). No statistically significant differences in the length of cerebellar tonsillar hernia and length of syringomyelia between the simple Chiari malformation group and the complex Chiari malformation group (P> 0.05).Conclusions The complex Chiari malformation shows a greater degree of compression on the medulla oblongata, but no significant effect on the activity of the medulla oblongata.
[Keywords] craniovertebral junction malformation；Chiari malformation；cervical vertebra；dynamic magnetic resonance imaging；cervico medullary angle

FANG Xiongyi1, 2   ZENG Wei1   PU Yongliang1   YANG Haitao1*  

1 Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

2 Department of Radiology, the Second People's Hospital of Neijiang City, Neijiang 641000, China

Corresponding author: YANG H T, E-mail: frankyang119@126.com

Conflicts of interest   None.

Received  2025-03-22
Accepted  2025-06-05
DOI: 10.12015/issn.1674-8034.2025.06.016
Cite this article as: FANG X Y, ZENG W, PU Y L, et al. Study on the evaluation of cervical medullary compression and activity in craniovertebral junction malformation used dynamic flexion-extension cervical spine MRI[J]. Chin J Magn Reson Imaging, 2025, 16(6): 110-115, 121. DOI:10.12015/issn.1674-8034.2025.06.016.

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