Imaging of lines of skull - Watch the head lines

Congress:

ECR 2020

Poster Number:

C-03229

Type:

Educational Exhibit

Keywords:

Not applicable, Congenital, Diagnostic procedure, CT, Anatomy, Head and Neck

Authors:

G. Ilangovan, L. KUMAR, H. Balaganesan; Chennai/IN

DOI:

10.26044/ecr2020/C-03229

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-03229

Fig. 1: FINDINGS: Craniometric lines: Chamberlaine line, Mc Gregor line and Mc Rae...

Fig. 2: FINDINGS : Schematic diagram showing Welcher basal angle (5).

Fig. 3: FINDINGS : Basilar invagination. Midsagittal T1-weighted MRI (A) reveals a...

Fig. 4: FINDINGS : CT axial section showing partial anterior arch rachischisis (yellow...

Learning objectives

·To perform an anatomical review of the normal cranio-cervical junction . ·To describe the main disorders associated with cranio-cervical junction .

Background

·Craniocervical junction is the anatomical region formed by the occipital bone, foramen magnus, clivus, atlas, axis, supporting ligaments and soft tissue structures of the cervico medullary junction (1,2) ·The ligaments connecting the bones are articular capsules, anterior atlantooccipital membrane, posterior atlantooccipital membrane, lateral ligaments and synovial membranes (1,2) ·Due to anatomic complexities of the CVJ and high frequency of craniocervical trauma with muscle spasm, plain radiographs pose limitations in accurate diagnosis(9). ·The cross-sectional imaging such as MDCT and MRI are used for for further diadnosis,...

Findings and procedure details

On different imaging modalities, a number of osseous reference points in this region are used to draw different lines and angles, which allows us to define the characteristics of the junction: ChamberlainandMc Gregor linesare drawn from the hard palate either to the opisthion, or to the lowest point of the occipital squamosal surface, respectively (Fig. 1). These lines assess the odontoid process relations, normally it is tangent or lies below to them (2) and the anterior arch of the atlas typically lies below both lines...

Conclusion

Due to the slow and silent course manifested by disorders of the cranio-cervical junction, it is mandatory to correctly diagnose anomalies of the region with an understanding of anatomy and craneometry. MRI is a technique especially useful in the evaluation of craniocervical junction anomalies.

Personal information and conflict of interest

Dr. I. Gurubharath MD Ph.D Professor & HOD Department of Radiodiagnosis Velammal Medical College Hospital & Research Institute Velammal, Madurai Tamil Nadu - 625009, India. Email: [email protected] Dr. Leena Kumar Postgraduate resident Department of Radiodiagnosis Shri Sathya Sai Medical College & Research Institute Chennai, Tamil Nadu- 603108, India E-mail: [email protected] Dr. Harshavardhan Balaganesan Senior resident Department of Radiodiagnosis Shri Sathya Sai Medical College & Research Institute Chennai, Tamil Nadu- 603108, India E-mail: [email protected] The authors have no conflict of interest.

References

1.Gray's anatomy 37th Ed Philadelphia, Pa: Lea & Febiger, 1989. 2.Smoker WRK Craniovertebral junction: normal anatomy, craniometry, and congenital anomalies. Radiographic 1994; 14:2555-7. 3.Chen YF, Liu HM. Imaging of craniovertebral junction. Neuroimaging Clinics of North America, 2009. 19(3), 483-510. 4.Téllez-Girón JR. Anatomía y patología de la unión craneovertebral. Anales de Radiología México, 2006. 2: 153-70. 5.A. B. Gil Guerra et al. Cranio-cervical junction: craniometry and anomalies. 10.1594/ecr2018/C-1697. 6.Imaging of Craniovertebral Junction. Radiologykey.com 7.Ramen Talukdar et al. Imaging In Craniovertebral Junction (CVJ) Abnormalities. IOSR Journal of...