PDF(Pubmed)
Abstract：
OBJECTIVE: Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment.
METHODS: A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454).
RESULTS: Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard\'s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease.
CONCLUSIONS: We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients\' PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.
METHODS: A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454).
RESULTS: Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard\'s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease.
CONCLUSIONS: We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients\' PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.
摘要：
目的：Chiari畸形I型（CMI）发展的影像学参数尚未确定。这项研究旨在收集CMI患者一般或特定影像学测量的证据，分析可能有助于确定CMI严重程度的指标，并指导其诊断和治疗。
方法：对包括CochraneLibrary在内的各种数据库进行了全面搜索，PubMed,MEDLINE,Scopus,和Embase,涵盖2002年1月至2023年10月期间，遵循预定义的纳入标准。使用RevMan（ver。5.4).我们对纳入的研究进行了定量总结和系统分析。本研究在启动前已在PROSPERO（国际前瞻性系统评价登记册）中注册（CRD42023415454）。
结果：33项研究符合我们的纳入标准。研究结果表明，在所检查的14个参数中，6（clivus长度，基底角,Boogard的角度,上枕骨长度，后颅窝[PCF]高度，和体积）在CMI组与对照组之间表现出显着差异。此外，除了某些对CMI具有预后价值的解剖参数外，功能参数，如扁桃体运动，obex位移,和脑脊液动力学是指导疾病临床治疗的有价值的指标。
结论：我们整理并建立了一组线性，角度,和面积测量被认为对诊断CMI至关重要。然而,更多的指标只能出于各种原因进行描述性分析，特别是在预后预测中。我们认为，对患者PCF形态学的系统评估，volume,等参数在三维水平上具有良好的临床应用前景。
方法：对包括CochraneLibrary在内的各种数据库进行了全面搜索，PubMed,MEDLINE,Scopus,和Embase,涵盖2002年1月至2023年10月期间，遵循预定义的纳入标准。使用RevMan（ver。5.4).我们对纳入的研究进行了定量总结和系统分析。本研究在启动前已在PROSPERO（国际前瞻性系统评价登记册）中注册（CRD42023415454）。
结果：33项研究符合我们的纳入标准。研究结果表明，在所检查的14个参数中，6（clivus长度，基底角,Boogard的角度,上枕骨长度，后颅窝[PCF]高度，和体积）在CMI组与对照组之间表现出显着差异。此外，除了某些对CMI具有预后价值的解剖参数外，功能参数，如扁桃体运动，obex位移,和脑脊液动力学是指导疾病临床治疗的有价值的指标。
结论：我们整理并建立了一组线性，角度,和面积测量被认为对诊断CMI至关重要。然而,更多的指标只能出于各种原因进行描述性分析，特别是在预后预测中。我们认为，对患者PCF形态学的系统评估，volume,等参数在三维水平上具有良好的临床应用前景。
