Purpose

Incidental cerebellar tonsillar ectopia (ICTE) that meets the radiographic criterion for Chiari malformation type I (CMI) is an increasingly common finding in the clinical setting, but its significance is unclear. The present study examined posterior cranial fossa (PCF) morphometrics and a broad range of health instruments of pediatric ICTE cases and matched controls extracted from the Adolescent Brain Cognitive Development (ABCD) dataset.

Methods

One-hundred-six subjects with ICTE and 106 matched controls without ICTE were identified from 11,411 anatomical MRI of healthy screened pediatric subjects from the ABCD project. Subjects were matched by sex, age, body mass index, race, and ethnicity. Twenty-two brain morphometrics and 22 health instruments were compared between the two groups to identify unrecognized CMI symptoms and assess the general health impact of ICTE.

Results

Twelve and 15 measures were significantly different between the ICTE and control groups for females and males, respectively. Notably, for females, the anterior CSF space was significantly smaller (p = 0.00005) for the ICTE group than controls. For males, the clivus bone length was significantly shorter (p = 0.0002) for the ICTE group compared to controls. No significant differences were found among the 22 health instruments between the two groups.

Conclusion

This study demonstrated that pediatric ICTE subjects have similar PCF morphometrics to adult CMI. ICTE alone did not appear to cause any unrecognized CMI symptoms and had no impact on the subjects’ current mental, physical, or behavioral health. Still, given their cranial and brain morphology, these cases may be at risk for adult-onset symptomatic CMI.

中文翻译：

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偶发小脑扁桃体异位的影像学和健康指标：青少年大脑认知发展研究 (ABCD) 的结果

目的

符合 Chiari 畸形 I 型 (CMI) 放射学标准的偶发性小脑扁桃体异位 (ICTE) 在临床环境中越来越常见，但其意义尚不清楚。本研究检查了从青少年脑认知发展 (ABCD) 数据集中提取的后颅窝 (PCF) 形态测量学和儿科 ICTE 病例和匹配对照的广泛健康工具。

方法

从 ABCD 项目的 11,411 名健康筛查儿科受试者的解剖 MRI 中确定了 16 名患有 ICTE 的受试者和 106 名没有 ICTE 的匹配对照。受试者按性别、年龄、体重指数、种族和民族进行匹配。比较了两组之间的 22 种脑形态测量学和 22 种健康仪器，以识别未识别的 CMI 症状并评估 ICTE 的一般健康影响。

结果

ICTE 和对照组的女性和男性分别有 12 项和 15 项措施显着不同。值得注意的是，对于女性来说，ICTE 组的前 CSF 空间明显小于对照组 ( p  =  0.00005)。对于男性，与对照组相比，ICTE 组的斜坡骨长度显着缩短 ( p  =  0.0002)。两组之间的22种健康仪器之间没有发现显着差异。

结论

这项研究表明，儿科 ICTE 受试者的 PCF 形态测量与成人 CMI 相似。单独的 ICTE 似乎不会导致任何无法识别的 CMI 症状，并且对受试者当前的心理、身体或行为健康没有影响。尽管如此，考虑到他们的颅骨和大脑形态，这些病例可能有成人发病的症状性 CMI 的风险。