RT Journal Article
SR Electronic
T1 Application of Normative Occipital Condyle-C1 Interval Measurements to Detect Atlanto-Occipital Injury in Children
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 958
OP 962
DO 10.3174/ajnr.A4641
VO 37
IS 5
A1 Corcoran, B.
A1 Linscott, L.L.
A1 Leach, J.L.
A1 Vadivelu, S.
YR 2016
UL http://www.ajnr.org/content/37/5/958.abstract
AB BACKGROUND AND PURPOSE: Prior studies have found that widening or asymmetry of the occipital condyle-C1 interval on CT is a sensitive and specific marker for atlanto-occipital dislocation. Previously reported abnormal occipital condyle-C1 interval values are not age-specific, possibly leading to false-positive findings in younger children, in whom this joint space is normally larger than that in adults. This study assesses the utility of applying age-specific normative occipital condyle-C1 interval ranges to documented cases of atlanto-occipital injury compared with previously reported abnormal cutoff values.MATERIALS AND METHODS: Retrospective review of CT and MR imaging of 14 subjects with atlanto-occipital injury was performed, and occipital condyle-C1 interval measurements were made for each subject. Sensitivities and specificities of proposed occipital condyle-C1 interval cutoffs of 2 and 3 SDs above the mean and previously published occipital condyle-C1 interval cutoffs for atlanto-occipital injury were then calculated on the basis of occipital condyle-C1 interval measurements for each subject.RESULTS: An occipital condyle-C1 interval 2 SDs above the age-specific mean has a sensitivity of 50% and specificity of 89%–100%, depending on the age group. An occipital condyle-C1 interval 3 SDs above the age-specific mean has a sensitivity of 50% and a specificity of 95%–100%. A 4.0-mm occipital condyle-C1 interval has a sensitivity of 36% and a specificity of 100% in all age groups. A 2.5-mm occipital condyle-C1 interval has a sensitivity of 93% and a specificity of 18%–100%.CONCLUSIONS: Occipital condyle-C1 interval widening cutoffs used to establish atlanto-occipital injury lack both sensitivity and specificity in children and young teenagers. MR imaging is necessary to establish a diagnosis of atlanto-occipital injury in children and young teenagers when the appropriate mechanism of injury is present.AODatlanto-occipital dislocationCCIoccipital condyle-C1 interval