MR imaging of the normal and abnormal clivus.

Kimura, Fumie; Kim, K. W.; Friedman, Henry L.; Russell, Eric J.; Breit, Robert

doi:10.2214/ajr.155.6.2122682

Cited by 50 publications

(64 citation statements)

References 2 publications

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“…2). Clivus bone marrow showing uniform low signal intensity was graded I, bone marrow consisting of mixed low and high signal intensity portions throughout the clivus was graded II, and clivus bone marrow showing high signal intensity was graded III; this grading system was used previously by Okada et al (1989), Kimura et al (1990), and Oyar et al (1996).…”

Section: Methodsmentioning

confidence: 99%

“…With the advent of MR imaging, which enables multiplanar visualization and lacks the beam-hardening artifact seen on computed tomography, the clivus is more thoroughly displayed than before, especially in the sagittal plane (Chaljub et al, 1992). Clivus bone marrow changes on MR imaging in a wide spectrum of diseases (including ␤-thalassemia, meningioma, chordoma, osteochondroma, fibrous dysplasia, plasmacytoma, chloroma, metastases, invasion of nasopharyngeal carcinoma, and AIDS), as well as marrow reconversion after chemotherapy, have been reported in the literature (Kimura et al, 1990;Chaljub et al, 1992;Maeda et al, 1993;Eustace et al, 1994). To evaluate any pathology in this region, the normal signal intensity patterns according to age should be known.…”

Section: Introductionmentioning

confidence: 99%

“…To evaluate any pathology in this region, the normal signal intensity patterns according to age should be known. To establish normal patterns of distribution of red and yellow marrow in clivus bone marrow according to age and gender, Kimura et al (1990), Okada et al (1989), Oyar et al (1996), and Simonson and Kao (1992) carried out MR imaging studies in which signal intensity patterns of clivus bone marrow were evaluated qualitatively, but not quantitatively.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of qualitative and quantitative analyses of age‐related changes in clivus bone marrow on MR imaging

et al. 2003

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Magnetic resonance (MR) imaging is capable of detecting a wide spectrum of diseases involving clivus bone marrow. To evaluate any pathology in this region, the normal MR signal intensity patterns according to age should be known. Assessment of clivus bone marrow is usually and more efficiently made visually (qualitatively) on routine MR imaging. To compare the qualitative and quantitative analyses of age-related changes in clivus bone marrow on MR imaging, midsagittal T1-weighted MR images of the clivus bone marrow were prospectively evaluated in 201 subjects. MR signal intensity patterns of clivus bone marrow were qualitatively graded from I to III according to the proportions of low and high signal intensity areas within the clivus (Grade I: predominantly hypointense, Grade III: predominantly hyperintense). Signal intensity measurements were also made from the clivus, pons, and the cerebrospinal fluid within the fourth ventricle. Grade I pattern was observed in 92% of the subjects in the first decade, whereas Grade III pattern was not seen in this decade; Grade I pattern was absent in all but one of the subjects over the age of 50. Mean values of clivus/pons and clivus/CSF signal intensity measurements gradually increased with age in both males and females. Comparison of these ratios in each gender showed statistically significant higher values for males (P < 0.05). Comparison of the qualitative and quantitative results showed that calculated mean values of intensity ratios for each grade were different from each other; however, there was an overlap of the ranges of signal intensity ratios for Grades II and III. Visual evaluation of the clivus bone marrow MR signal is validated with the quantitative assessment results. Statistically significant higher intensity ratios in males may reflect a difference between gender in the bone mineral content under the influence of sex hormones.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of qualitative and quantitative analyses of age‐related changes in clivus bone marrow on MR imaging

et al. 2003

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“…3,44,[55][56][57]61 Chordomas are by far the most common tumors arising from the clivus. 38,43 Emanating from remnants of the notochord, chordomas exhibit slow expansile growth with infiltration and destruction of bone as well as compression of adjacent neurovascular structures. 28 Although typically extradural, these lesions can invade the dura and extend intradurally.…”

Section: Current State Of the Art In Surgical Approaches For Clival Lmentioning

confidence: 99%

Surgery for clival lesions: open resection versus the expanded endoscopic endonasal approach

Carrabba¹,

Dehdashti²,

Gentili³

2008

FOC

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Object Clival lesions pose significant challenges with regard to their surgical management. The expanded endoscopic endonasal (EEE) approach is a promising minimally invasive technique for lesions of the central skull base. The authors' aim in the current paper was to discuss the surgical treatment of clival lesions and to present the technical details, indications, and limitations of the EEE approach. Data from a recent endoscopically treated group will be compared with findings in a previous cohort of patients treated via classic open anterior and lateral approaches. Methods Since June 2005, 17 patients with clival lesions underwent surgery via the EEE approach. Suitable candidates were chosen according to lesion characteristics, clinical parameters, and surgical goals. Neurological outcomes, Karnofsky Performance Scale scores, the extent of lesion resection, and complications were evaluated among these patients. Eighteen percent of the patients in the endoscopic group presented with recurrent disease. Another series of 43 patients, who had undergone resection of clival lesions via an anterior (rhinotomy, maxillectomy, microscopic transsphenoidal surgery, or transoral surgery) or lateral (pterional, frontoorbitozygomatic, or combined suprainfratentorial retrosigmoid) approach, was similarly reviewed. Twenty-three of these patients (53%) presented with recurrent disease and thus had undergone prior surgery. Results Following the EEE approach, 11 (79%) of 14 patients who had presented with neurological symptoms experienced improvement, and gross-total resection was achieved in 59% of the patients and subtotal removal in 41%. Complications included CSF leakage (24%), tension pneumocephalus (6%), and intracranial hematoma (6%). The patient with the latter complication was the only one who experienced permanent neurological worsening. In the open resection group, neurological worsening occurred in 33% of the patients (14 of 43). Total and grosstotal removals were achieved in 84% of patients and subtotal removal in 14%. Conclusions The EEE approach has been shown to be a safe and effective technique for the resection of clival lesions with limited lateral extension. The choice of surgical approach must be tailored according to both patient and tumor characteristics. Although the 2 patient series featured in this paper are not comparable—because of a selection bias—higher rates of neurological morbidity and total and gross-total resections were observed in the open resection group. Given the long survival of some patients, the EEE approach should be favored whenever reasonable.

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“…This technique was proven useful in the assessment of bone marrow pathologies and metastatic marrow diseases (18,19). Some studies utilized conventional MRI to evaluate signal characteristics of cranial marrow (14,18,(20)(21)(22). Some authors found that MRI findings could be used as predictors for distinguishing leukemic patients from normal controls, providing more accurate diagnosis (7).…”

Section: Discussionmentioning

confidence: 99%

Role of diffusion-weighted imaging for detecting bone marrow infiltration in skull in children with acute lymphoblastic leukemia

Cao

Liang

Gen³

et al. 2016

Diagn Interv Radiol

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MR imaging of the normal and abnormal clivus.

Abstract: We retrospectively reviewed head MR images in a group of 330 adult patients (1 97 women and 1 33 men 20-88 years old) to establish the normal MR appearance of the clivus on

Cited by 50 publications

References 2 publications

Comparison of qualitative and quantitative analyses of age‐related changes in clivus bone marrow on MR imaging

Comparison of qualitative and quantitative analyses of age‐related changes in clivus bone marrow on MR imaging

Surgery for clival lesions: open resection versus the expanded endoscopic endonasal approach

Role of diffusion-weighted imaging for detecting bone marrow infiltration in skull in children with acute lymphoblastic leukemia

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